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Women are less likely to be diagnosed with minor stroke than men

May 22, 2019

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Women experiencing a minor stroke or transient ischemic attack (TIA) are less likely to be diagnosed with a stroke compared to men — even though they describe similar symptoms in emergency departments.

“In our study, men were more likely to be diagnosed with TIA or minor stroke, and women were 10 per cent more likely to be given a non-stroke diagnosis, for example migraine or vertigo, even though men and women were equally likely to report atypical stroke symptoms,” says study lead author Dr. Amy Yu, a stroke neurologist at Sunnybrook Health Sciences Centre and assistant professor at the University of Toronto.

The findings of the study are published in JAMA Neurology and were presented May 22 at the European Stroke Organisation Conference in Milan, Italy.

The study found men and women equally described atypical stroke symptoms such as dizziness, tingling or confusion which are not commonly thought of as related to stroke. Typical symptoms of stroke are sudden weakness, face drooping or speech difficulties.

A TIA occurs when there is temporary interruption of blood flow to the brain, and is often a warning sign of another stroke. TIAs can also be associated with permanent disability.

“Our study also found the chance of having another stroke or heart attack within 90 days of the diagnosis was the same for women and men,” adds senior author Dr. Shelagh Coutts, MD, a stroke neurologist with Alberta Health Services at Foothills Medical Centre, associate professor at the University of Calgary’s Cumming School of Medicine (CSM) and member of the Hotchkiss Brain Institute at the CSM.

Researchers say while further research is needed, it is possible that patient reporting of symptoms, interpretation of symptoms by clinicians, or a combination of both, could explain the discrepancy in diagnosis among men and women.

“Our findings call attention to potential missed opportunities for prevention of stroke and other adverse vascular events such as heart attack or death in women,” adds Dr. Coutts.

Previous studies on this topic have focused on patients diagnosed with stroke. Researchers in the current study included 1,648 patients with suspected TIA who were referred to a neurologist after receiving emergency care from 2013-2017, regardless of their final diagnosis.

Researchers note it is an important opportunity for the public and clinicians to be aware of atypical symptoms of TIA.

“What’s important to recognize in stroke is that the brain has so many different functions and when a stroke is happening, people can feel different things beyond the typical stroke symptoms,” says Dr. Yu. “Accurately diagnosing TIA and stroke would change a patient’s treatment plan and could help prevent another stroke from happening.”

Funding for the study was provided by Genome Canada, Genome CB, Genome Alberta, and the Heart and Stroke Foundation of Canada

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Media contact:
Jennifer Palisoc
Communications & Stakeholder Relations
Jennifer.palisoc@sunnybrook.ca
416-480-4040

About Sunnybrook

Sunnybrook Health Sciences Centre is inventing the future of health care for the 1.3 million patients the hospital cares for each year through the dedication of its more than 10,000 staff and volunteers. An internationally recognized leader in research and education and a full affiliation with the University of Toronto distinguishes Sunnybrook as one of Canada’s premier academic health sciences centres. Sunnybrook specializes in caring for high-risk pregnancies, critically-ill newborns and adults, offering specialized rehabilitation and treating and preventing cancer, cardiovascular disease, neurological and psychiatric disorders, orthopaedic and arthritic conditions and traumatic injuries. The Hospital also has a unique and national leading program for the care of Canada’s war veterans.

About University of Toronto Faculty of Medicine

World-class talent, interdisciplinary excellence, and collaboration with peers and partners have helped the University of Toronto Faculty of Medicine continually solve the world’s most pressing medical challenges since 1843. We are Canada’s largest Faculty of Medicine, with more than 8,000 faculty members and 7,600 students enrolled in undergraduate medicine, postgraduate medicine, radiation sciences, and professional and doctoral graduate programs. We partner with nine fully affiliated hospitals and 20 community-affiliated hospitals and health facilities. This partnerships fuels a thriving research enterprise — one of the largest in North America — that includes one-fifth of all health and biomedical Canada Research Chairs and has attracted $864 million in research funding (2017-18). In 2018, the National Taiwan University Ranking placed U of T Medicine first in Canada and third in the world in clinical medicine. medicine.utoronto.ca

About the University of Calgary

The University of Calgary is a global intellectual hub located in Canada’s most enterprising city. In our spirited, high-quality learning environment, students thrive in programs made rich by research, hands-on experiences and entrepreneurial thinking. Our strategy drives us to be recognized as one of Canada’s top five research universities, engaging the communities we both serve and lead. This strategy is called Eyes High, inspired by the university's Gaelic motto, which translates as 'I will lift up my eyes.' For more information, visit ucalgary.ca

About The Hotchkiss Brain Institute

The Hotchkiss Brain Institute (HBI) at the University of Calgary consists of more than 140 scientists and clinician-scientists who are dedicated to advancing brain and mental health research and education. The Institute’s research strengths, in Brain & Behaviour, Neural Injury & Repair and Healthy Brain Aging, are leading to a better understanding of the brain and nervous system and new treatments for neurological and mental health disorders, aimed at improving quality of life and patient care. More information about the HBI can be found at hbi.ucalgary.ca