Stroke women more often affected

Stroke: Contrary to popular opinion, women are more affected than men

15/12/2014

Usually, people of retirement age who are struggling with obesity, diabetes, and high cholesterol are considered to be the usual risk group for brain infarcts. This common cliché deceives the fact that women are more likely to be affected by strokes than men. „55 percent of the approximately 270,000 strokes in Germany occur each year“, explains Prof. Thomas Els, chief physician of the Department of Neurology at the Marien-Hospital Bergisch Gladbach. „Moreover, female patients later enter the rescue emergency room as a male. And they then remain in need of care more often“, so the doctor.

And that although women are actually better protected by their gender than men: „The female sex hormones dilate the arteries and prevent vascular deposits. This is why women have fewer cardiovascular diseases than men until menopause“, explains Thomas Els.

Women are more at risk, especially after menopause
Nevertheless, the situation is aggravated by the fact that the symptoms in women are often very unspecific and strokes are therefore often diagnosed with delay. Not infrequently a stroke is mistakenly confused by those affected with the headache of a migraine attack.

With increasing age, the hormonal advantage towards men also disappears. After menopause, women are even more vulnerable to triggering risks than men. For example, smoking in women increases the risk of stroke by three times, which is twice as high as that of men. And diabetes and high blood pressure endanger women to a much greater extent than men.

Atrial fibrillation is also more common in women over 65 than in men. In such cases, anticoagulant drugs are usually prescribed.
These findings have led to the development of prevention and treatment guidelines specifically for women in the United States. A path that doctors welcome in this country, too: „You can no longer throw women and men into cerebral infarction.“
Another risk factor may be hormone replacement therapy. According to an older study, it is suspected to cause more strokes and heart attacks. Recent studies have relativized these findings. And certain drugs increase the risk of stroke for women. Even the hormonal benefit before the menopause can become secondary. Thus, triptans are suspected of acting stroke favoring.

Non-specific symptoms
Another problem is that in addition to the usual stroke symptoms also occur nonspecific, which are not interpreted correctly by the rescue services, thus delaying a quick diagnosis: „In addition, female patients often report nonspecific symptoms such as shortness of breath, nausea, body aches or orientation problems“, explains the radiologist Prof. Marcus Seemann from the Diagnoseklinik München. „In such cases, the rescuer has more problems to recognize the emergency.“ In addition, women would have the habit of downplaying the problems in order not to burden anyone. All this means that the exact diagnosis is delayed and women are often not admitted to the clinic in time. But a quick treatment is obligatory. Approximately four and a half hours stay with the doctors for a successful treatment: „As long as the clot can be resolved in many cases with an anticoagulant drug.“ Even a surgical intervention can bring help. However, hurry is required in any case.
Dr. Sailor: „In an ischemic insult, just under 2 million nerve cells are lost every minute.“ In 15 percent of cases, a stroke is not triggered by a closed vessel, but by a cerebral hemorrhage - referred to in the jargon hemorrhagic insult: „An artery has burst, blood escapes and compresses the sensitive nerve tissue.“ This expansion, it is necessary to curb. Such cerebral hemorrhage can only be diagnosed using computed tomography (CT) or magnetic resonance therapy (MRI).

Strokeunits offer best care
So-called stroke units offer the best chance of surviving the storm in your head. All-round care by neurologists, cardiologists, neuro-vascular surgeons and radiologists improves the chances of patients leaving the hospital without paralysis by 25 percent. (Jp)