Stroke and Gender Differences
‘ Biologically interesting…socially consequential’

Men and women differ significantly in the way they describe their symptoms during a stroke, says Lewis Morgenstern (M.D. 1990), director of the U-M Stroke Program. The difference can affect how and when women receive emergency stroke treatment.

Lewis Morgenstern and stroke patient Valdina Wiley Photo: Martin Vloet

In research published in the November 2002 issue of the Annals of Emergency Medicine, Morgenstern described how women were 62 percent more likely than men to describe sensations other than the traditional symptoms of sudden weakness or numbness on one side of the body, difficulty speaking or understanding, facial drooping, dizziness or vision changes. The study, conducted with colleagues at the University of Texas, is the first to document significant gender differences in the perception and reporting of stroke symptoms.

Because emergency responders and emergency room physicians often go by patients' descriptions and the traditional symptom list when diagnosing and treating a suspected stroke, women’s symptoms may be overlooked during the precious hours when stroke therapies work best, says Morgenstern. Delayed treatment can mean long-term disability or even death from a stroke.

“These gender differences are both biologically interesting and socially consequential,” says Morgenstern, an associate professor of neurology, epidemiology, emergency medicine and neurosurgery in the U-M Medical School and the U-M School of Public Health. “They are important to medical education, too, because often medical students are trained that stroke is a man’s disease, which it is not.”

Previous studies have shown that women who have a stroke are more likely to die than men, or if they survive, more likely to have a poor outcome. Researchers also have discovered that women face longer delays than men in being evaluated for a stroke by emergency room physicians. Stroke is the leading cause of disability in American adults, and the third leading cause of death.

—KG

For more details on stroke prevention and warning signs, visit: www.med.umich.edu/1libr/topics/brain13.htm