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Sex differences in the evaluation and treatment of acute ischaemic stroke

Bushnell, C, Howard, VJ, Lisabeth, L, Caso, V, Gall, S ORCID: 0000-0002-5138-2526, Kleindorfer, D, Chaturvedi, S, Madsen, TE, Demel, SL, Lee, S-J and Reeves, M 2018 , 'Sex differences in the evaluation and treatment of acute ischaemic stroke' , The Lancet Neurology, vol. 17, no. 7 , pp. 641-650 , doi: 10.1016/S1474-4422(18)30201-1.

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Abstract

With the greater availability of treatments for acute ischaemic stroke, including advances in endovascular therapy, personalised assessment of patients before treatment is more important than ever. Women have a higher lifetime risk of stroke; therefore, reducing potential sex differences in the acute stroke setting is crucial for the provision of equitable and fast treatment. Evidence indicates sex differences in prevalence and types of non-traditional stroke symptoms or signs, prevalence of stroke mimics, and door-to-imaging times, but no substantial differences in use of emergency medical services, stroke knowledge, eligibility for or access to thrombolysis or thrombectomy, or outcomes after either therapy. Women presenting with stroke mimics or non-traditional stroke symptoms can be misdiagnosed, which can lead to inappropriate triage, and acute treatment delays. It is essential for health-care providers to recognise possible sex differences in stroke symptoms, signs, and mimics. Future studies focused on confounders that affect treatment and outcomes, such as age and pre-stroke function, are also needed.

Item Type: Article
Authors/Creators:Bushnell, C and Howard, VJ and Lisabeth, L and Caso, V and Gall, S and Kleindorfer, D and Chaturvedi, S and Madsen, TE and Demel, SL and Lee, S-J and Reeves, M
Journal or Publication Title: The Lancet Neurology
Publisher: Lancet Pub. Group
ISSN: 1474-4422
DOI / ID Number: 10.1016/S1474-4422(18)30201-1
Copyright Information:

© 2018 Elsevier Ltd.

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