Women And Men Often Feel Strokes Differently

Females report more nontraditional signs, study says

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HealthDay Reporter

FRIDAY, Oct. 25, 2002 (HealthDayNews) -- Women and men often give markedly different descriptions of their stroke symptoms, a fact that may confound diagnosing the vessel attacks and delay treatment, a new study shows.

Most stroke patients report roughly the same general battery of signs, including broken speech, facial paralysis, dizziness and various sensory problems. However, women in the study were about 60 percent more likely than men to report other symptoms not generally associated with strokes, such as limb pain, disorientation and fluctuations in consciousness.

Women did have more episodes of bleeding, or hemorrhagic, strokes, than men, who are more prone to blocked blood supply that triggers the attack. That might affect the way each experience the illness. Yet Dr. Lewis Morgenstern, director of the stroke center at the University of Michigan Medical School in Ann Arbor and a co-author of the study, says that doesn't fully explain the split.

"Either the experience of stroke is really different for some biological reason, or men and women experience the same phenomenon and explain it differently," Morgenstern says.

Whatever the case, Morgenstern says, doctors should look for stroke in women complaining of unconventional symptoms, since "time is of the essence" for effective treatments such as clot-busting drugs. "Trying to get past the clouds of what patients are saying could be very important for making a rapid diagnosis and instituting proper treatment," he says. A report on the findings appears in the November issue of the Annals of Emergency Medicine.

That women and men have different stroke symptoms shouldn't be surprising, experts says. Doctors have long known the two sexes often show dissimilar signs of other cardiovascular problems, notably heart attack.

The new study was based on 1,124 men and women with confirmed strokes seeking treatment at 10 hospitals in rural Texas. A doctor reviewed the case files without knowing the gender of the patients.

Twenty-eight percent of women reported having stroke symptoms not commonly found in textbooks, compared with 19 percent of men, the researchers found. Women were 50 percent more likely than men to say they experienced pain during the episode (12 percent versus 8 percent) or a change in consciousness (17 percent versus 12 percent). They also had more non-neurologic symptoms, such as chest pain and shortness of breath.

Men were a third more likely than women to have trouble with balance or partial paralysis, both of which are considered typical stroke symptoms.

Almost 60 percent of patients reported two or more symptoms.

Morgenstern, who conducted the study while at the University of Texas in Houston, says it's not clear if the gender differences in stroke symptoms is delaying treatment in some women. However, women do account for about 62 percent of stroke deaths in the United States, though they suffer more of the events than men by living longer.

An estimated 600,000 Americans suffer strokes each year, and 160,000 die from the attacks, according to the American Stroke Association. Stroke is the country's third leading killer and a chief cause of disability.

What To Do

For more on strokes and how to recognize them, visit the National Stroke Association or the National Institute of Neurological Disorders and Stroke.

SOURCES: Lewis Morgenstern, M.D., director, stroke program, University of Michigan Medical School, Ann Arbor; November 2002 Annals of Emergency Medicine

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