Acute Stroke Symptoms: Do Differences Exist between Sexes?

Background: Previous studies have reported that women with stroke often present different stroke symptoms than men. The aim of our study was to assess for the relevance of these differences from a large case series. Methods: Consecutive patients admitted to the Stroke Unit at the University of Perugia, with acute stroke or transient ischemic attack between 1 June, 2005, and May 2012, and recorded in Perugia Stroke Registry were prospectively included. Associations between the recorded symptoms and sex were assessed by preliminary cross-tabulations with the Chi-square test or Fisher exact test with Yate correction when appropriate. Multivariable regression analysis was used to identify independent predictors of a single symptom including sex as an independent variable. Results: Overall, 1072 men and 811 women were included in this study. Women had a higher average age at onset (75.40 +/- 12.90 years in women and 70.14 +/- 12.61 years in men) and presented more severe strokes with higher National Institute of Health Stroke Scale scores than men, whereas men were more likely to have a posterior stroke. Regarding symptoms, multivariate analysis revealed correlations between postural instability and male sex and between dysphagia and female sex. Conclusions: We found no differences in the clinical presentation of stroke between the sexes, except that men were more likely to have postural instability and females were more likely to have dysphagia. These findings suggest that stroke locations and stroke severity were associated with sex.