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Gender Gap in Stroke Symptoms?

Study: Women May Be More Likely Than Men to Experience 'Nontraditional' Stroke Symptoms

By Miranda Hitti
WebMD Health News

Reviewed by Louise Chang, MD

June 16, 2009 -- Women may be more likely than men to have "nontraditional" stroke symptoms, especially disorientation, confusion, or loss of consciousness, according to a new study.

The University of Michigan's Lynda Lisabeth, PhD, and colleagues studied 470 people who were treated at the University of Michigan Hospital for ischemic (clot-related) stroke or TIA (transient ischemic attack). They didn't study people who had hemorrhagic (bleeding) strokes.

Most strokes are ischemic. In an ischemic stroke, a blood clot interrupts the blood supply to part of the brain. A similar thing happens in a TIA; the symptoms of TIA are similar to a stroke, but they don't last. TIAs are often called "mini strokes."

Well-known symptoms of stroke or TIA include:

Sudden weakness or numbness in the face, arm, or leg on one side of the body.
Abrupt loss of vision, strength, coordination, sensation, speech or the ability to understand speech. These symptoms may become more marked over time.
Sudden dimness of vision, especially in one eye.
Sudden loss of balance, possibly accompanied by vomiting, nausea, fever, hiccups, or trouble with swallowing.
Sudden and severe headache with no other cause followed rapidly by loss of consciousness -- indications of a stroke due to bleeding.
Brief loss of consciousness.
Unexplained dizziness or sudden falls.

Stroke is a medical emergency, so call 911 if you or someone you know experiences stroke symptoms. And do so as soon as possible -- clot-busting stroke drugs must be given ASAP.

Studying Stroke Symptoms

The new study, published in the June 1 edition of Stroke, defines nontraditional stroke symptoms as including:

Pain in the face or half of the body
Mental change status (disorientation, confusion, or loss of consciousness)
Lightheadedness
Headache
General neurological symptoms (nausea, hiccups, weakness)
Non-neurological symptoms ( chest pain, palpitations, shortness of breath)

"Traditional" stroke symptoms included:

Numbness or paralysis on one side of the body
Trouble speaking or understanding speech
Double vision or other vision problems
Facial weakness
Coordination problems
Vertigo

Lisabeth's team asked the patients (or a friend or relative, if the patient couldn't speak) about the patients' stroke symptoms.

Most of the stroke or TIA patients experienced "traditional" stroke symptoms or a combination of traditional and nontraditional stroke symptoms. Only 4% of the women and 3% of the men only had nontraditional stroke symptoms.

Nontraditional stroke symptoms were reported by 116 women (52%) compared to 104 men (44%). Lisabeth and colleagues considered various other factors and concluded that women were 42% more likely than men to report at least one nontraditional TIA or stroke symptom.

Mental status change was the most common nontraditional stroke symptom, which was reported by 23% of the women and 15% of the men.

The researchers caution that that finding could have been due to chance. But since other studies have shown similar patterns, Lisabeth's team calls for larger studies to look for gender gaps in TIA or ischemic stroke symptoms.

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