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Gender Differences in Stroke: Etiology, Patterns, and Treatment Response

This study explores the differences between men and women in relation to stroke, including etiology, stroke patterns, and response to thrombolysis treatment. The findings highlight the need for gender-specific diagnostic and therapeutic approaches in stroke management.

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Gender Differences in Stroke: Etiology, Patterns, and Treatment Response

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  1. LE DIFFERENZE DI GENERE NELLE DEMENZE San Benedetto del Tronto, 1-2 Dicembre 2017 MALATTIE CEREBROVASCOLARI E DIFFERENZE DI GENERE Maria Vittoria Calloni UO Neurologia Stroke Unit Ospedale di Legnano ASST Ovest Milanese maria.calloni@asst-ovestmi.it

  2. Stroke in women

  3. European Cardiovascular Disease Statistics , 2012

  4. Hormones

  5. Genes

  6. Common Cerebrovascular Risk factors

  7. Common Cerebrovascular Risk factors

  8. Specific risk factors

  9. Donne • Ridotta incidenza Rischio di stroke più alto durante la vita( aumentata aspettativa di vita) • Insorgenza in età più avanzata • Istituzionalizzazione : donne 7.9% – uomini 3.9% • USA 53% nuovi stroke/ anno nelle donne Seshadri : the lifetimeriskofstroke: estimatesfrom the Framinghamstudy – Stroke 2006 Petrea : Gender differences in strokeincidence in the FraminghamHeartStudy-Stroke 2009 Wieberdink: trends in strokeincidencerates and strokeriskfactors in Rotterdam from 1990-2008 Europ.J . Epidemiol. 2012

  10. 2013 Dec;44(12):3401-6. Does sex influence the responsetointravenousthrombolysis in ischemicstroke?: answersfromsafeimplementationoftreatments in Stroke-InternationalStrokeThrombolysisRegister.Lorenzano S1, Ahmed N, Falcoukulik R, Tatlisumak T, Roffe C, WahlgrenN, Toni D; SITS Investigators.

  11. Bushnell, 2008 Marini , Stroke 2005

  12. Sex differences in clinical presentation •Women tend to have anterior circulation ischemia, whereas men are believed to have higher incidences of posterior circulation syndromes •Labiche et al have reported that females at stroke onset were more likely to present with ‘‘non-traditional’’ stroke symptoms compared with men (pain and reduced level of consciousness) •Females tended to have higher NIHSS at admission

  13. Volume: 7 issue: 3, page(s): 383-390

  14. Efficacy and safety assessment of alteplase in the treatment of stroke — gender differences A Lasek Bal

  15. Future directions : Gender Medicine Gender-specific medicine aims at: •understanding how different clinical signs, diagnostic procedures and therapeutic needs are in men and women • developing sex tailored diagnostic and therapeutic approach •establishing a close cooperation between research centres, universities and public institution to promote a ‘new style of doing research’ and to improve public awarness of women’s health

  16. 26 marzo 2017 Grazie

  17. Gender Differences in Acute Ischemic Stroke Etiology, Stroke Patterns and Response to Thrombolysis Alex Förster, MD; Achim Gass, MD; Rolf Kern, MD; Marc E. Wolf, MD; Caroline Ottomeyer, MD; Katrin Zohsel, PsyD; Michael Hennerici, MD; Kristina Szabo, MD From the Department of Neurology, Universitätsklinikum Mannheim, University of Heidelberg, Mannheim, Germany. Abstract Background and Purpose— Differences between women and men in relation to stroke are increasingly being recognized. Methods— From July 2004 until June 2007, 237 acute ischemic stroke (AIS) patients were treated with recombinant tissue plasminogen activator (rtPA) within 3 hours after onset of symptoms in our stroke unit. Baseline characteristics, etiology, CT/MRI stroke patterns, clinical outcome, and complications of women were compared to those of men. Results— Of 237 AIS patients (mean age 70.7 years), 111 (46.8%) were women and 126 (53.2%) were men. Women were older (P=0.001), but history of hyperlipidemia (P=0.03), smoking (P=0.03), and coronary heart disease (P<0.001) was less frequent than in men. Internal carotid artery disease occurred more often in men (P=0.02), whereas atrial fibrillation was observed more often in women (P=0.002). In men borderzone/small embolic and lacunar stroke was found more frequently (39.7 versus 27.2%), whereas women showed a higher percentage of large territorial stroke (72.8 versus 60.3%, P=0.09). Baseline National Institute of Health Stroke Scale scores (12.5 versus 11.3), NIHSS score at discharge (11.0 versus 9.5), 3-month-outcome modified Rankin Scale score, thrombolysis-related (17.1% versus 13.5%) or independent complications (32.4% versus 30.2%), and mortality after 3 months (13.5% versus 9.5%) were similar. Conclusion— Differences of stroke lesion patterns in genders are paralleled by differences in etiology and risk factor profiles (women, cardioembolism; men, large and small vessel disease). Baseline characteristics, rates of rtPA-related and independent complications, as well as clinical outcomes were not different between women and men with AIS. (Stroke. 2009;40:2428-2432.)

  18. Sex differences in clinical presentation

  19. Why stroke is more severe in women ?

  20. Sex differences in clinical presentation

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