Sex differences in the evaluation and treatment of acute ischaemic stroke

Cheryl Bushnell, Virginia J. Howard, Lynda Lisabeth, Valeria Caso, Seana Gall, Dawn Kleindorfer, Seemant Chaturvedi, Tracy E. Madsen, Stacie L. Demel, Seung Jae Lee, Mathew Reeves

Research output: Contribution to journalReview articlepeer-review

33 Scopus citations


With the greater availability of treatments for acute ischaemic stroke, including advances in endovascular therapy, personalised assessment of patients before treatment is more important than ever. Women have a higher lifetime risk of stroke; therefore, reducing potential sex differences in the acute stroke setting is crucial for the provision of equitable and fast treatment. Evidence indicates sex differences in prevalence and types of non-traditional stroke symptoms or signs, prevalence of stroke mimics, and door-to-imaging times, but no substantial differences in use of emergency medical services, stroke knowledge, eligibility for or access to thrombolysis or thrombectomy, or outcomes after either therapy. Women presenting with stroke mimics or non-traditional stroke symptoms can be misdiagnosed, which can lead to inappropriate triage, and acute treatment delays. It is essential for health-care providers to recognise possible sex differences in stroke symptoms, signs, and mimics. Future studies focused on confounders that affect treatment and outcomes, such as age and pre-stroke function, are also needed.

Original languageEnglish (US)
Pages (from-to)641-650
Number of pages10
JournalThe Lancet Neurology
Issue number7
StatePublished - Jul 2018

ASJC Scopus subject areas

  • Clinical Neurology


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