Stroke Symptoms Differ In Women, Men

Female stroke victims are less likely to report classic stroke symptoms than men — one possible explanation for why they aren't as likely to get a crucial stroke drug.

The new research found that female stroke victims are 33 percent less likely to report a classic stroke symptom when they arrive at the emergency room than their male counterparts.

The finding comes at a time when research shows women who suffer strokes are much less likely to be given the clot-busting drug tPA than men, notes researcher Julia Warner Gargano, M.S., an epidemiologist at Michigan State University in East Lansing.

The most common type of stroke, an ischemic stroke, occurs when blood flow to an area of the brain is compromised by a blood clot. This leads to the death of brain cells and brain damage.

"It's a quandary," says American Stroke Association spokesman Larry Goldstein, M.D., a neurologist at Duke University who was not involved with the work. "Women tend to have more symptoms that are very vague, so it's hard to ascribe them to stroke. And if it's not promptly diagnosed as stroke, it won't be treated as a stroke," he tells WebMD.

"If a woman tends to have a lot of headaches and she comes in with another headache, why would you even begin to think it's a stroke?" Goldstein asks.

Gargano's study was presented at the American Stroke Association's International Stroke Conference 2007.

For the study, researchers reviewed the records of 1,724 people who were ultimately confirmed to have had a stroke. Nine percent of the men and 13 percent of the women did not report any of the five classic stroke warning signs: sudden numbness or weakness of the face, arm, or leg, especially on one side; sudden confusion or trouble speaking; sudden trouble seeing; difficulty walking, dizziness or loss of balance; or a sudden severe headache with no known cause.

The most common complaints among women without any of the five warning signs: loss of consciousness or fainting, difficulty breathing, pain, and seizures.

Gargano says additional research is needed to determine if the uncharacteristic symptoms explain why women experience treatment delays.

According to the American Stroke Association, 373,000 women suffered a stroke in 2004 vs. 327,000 men; 91,487 women died of a stroke that year compared to 58,660 men.

Also at the meeting, Los Angeles researchers reported that women aged 45 to 54 are twice as likely to report having had a stroke than men.

The reason: A high rate of stroke risk factors — including plaque-clogged arteries leading to the brain, high blood pressure, high cholesterol, and tummy fat — among women, says researcher Amytis Towfighi, M.D., of the UCLA Stroke Center.

"Less than half of women knew what healthy blood pressure and cholesterol levels are, and less than half knew their own reading," she says. Making matters worse: Health care practitioners also underestimated women's risk factors, she says.

"The more women learn about the warning signs, symptoms, and treatment of stroke, the more they can help themselves, Towfighi tells WebMD.

For their study, the researchers analyzed data collected by the National Center for Health Statistics on more than 15,000 adults between 1999 and 2002.

SOURCES: International Stroke Conference, Feb. 7-9, 2007, San Francisco. Julia Warner Gargano, M.S., Michigan State University, East Lansing. Larry Goldstein, M.D., department of neurology, Duke University; spokesman, American Stroke Association. Amytis Towfighi, M.D., UCLA Stroke Center. American Heart Association: "Heart Disease and Stroke Statistics — 2007 Update."

By Charlene Laino
Reviewed by Louise Chang