Strokes different in men vs. women

Researchers are investigating factors that could cause significant gender disparities in the impact and care received when stroke occurs.

By Victoria Stagg Elliott, AMNews staff. May 23/30, 2005.

The woman had been at a financial planning conference when she suddenly had double vision. It eventually returned to normal. Still, over the next few days, she realized she was having a hard time reading. The problem ultimately led her to the office of Barbara Kostick, MD, a family physician in Freemont, Calif.

This scenario is not usually considered a stroke, but that's exactly what it was -- a small stroke.

"These were atypical symptoms," Dr. Kostick said. "And she didn't run to emergency room."

It is stories such as these, along with increasing evidence that women's stroke symptoms could be very different from men's and that this variation might contribute to significant disparities in outcomes, that have prompted scientists to start investigating the circumstances prospectively.

Researchers at the University of Michigan Health System, Ann Arbor, announced last month that they are interviewing every man and woman presenting to their emergency department with any sign of a stroke. The goal is to determine what patients felt and how they described it in hopes of confirming various stroke-related gender differences.

"Men have more classical symptoms of stroke, but women are experiencing other symptoms," said Lewis Morgenstern, MD, director of the University of Michigan Comprehensive Stroke Program. "We may have to go back and change the textbooks."

This research is in part an outgrowth of the emerging awareness that cardiovascular disease strikes women at high rates, and, much like heart attacks, how women present could play a role in higher death and disability rates. Epidemiological data suggest that women tend to take longer to get to the emergency department, if they make it there at all.