The following is a summary of “Sex differences in acute ischemic stroke presentation are a matter of infarct location,” published in the December 2023 issue of Emergency Medicine by Higgins, et al.

Identifying stroke promptly through Emergency Medical Services (EMS) is crucial for initiating timely treatment in the emergency department. While prehospital stroke screening tools typically rely on classic symptoms like facial droop, speech changes, and unilateral weakness, there is evidence suggesting that women may present differently and have varied stroke locations. For a study, researchers sought to explore the relationship between biological sex, classic symptom presentation, and infarct location.

The retrospective cohort study analyzed electronic health records of patients with acute ischemic stroke arriving via EMS at a single Comprehensive Stroke Center from January 1, 2018, to December 31, 2020. Descriptive statistics characterized the cohort, while multivariable logistic regression assessed factors associated with classic symptom presentation, including biological sex, infarct location, stroke etiology, age, and their interactions.

Among the 621 patients, 364 (58.6%) were male and 257 (41.1%) were female. EMS documented classic symptoms in 72.3% of males and 67.9% of females. Baseline differences in infarct location or classic symptom presentation by EMS were not observed between males and females. Multivariate logistic regression revealed no association between biological sex and classic symptom presentation (Odds Ratio 1.08; 95% CI 0.58 to 1.55) after controlling for age, stroke location, etiology of stroke, or the interaction between sex and infarct location. However, anterior circulation infarcts were significantly associated with classic symptom presentation to EMS (Odds Ratio 3.41; 95% CI 2.15 to 5.41).

The study suggested no difference in classic stroke symptom presentation based solely on biological sex or infarct location between males and females. Instead, the infarct’s location, particularly the involvement of the anterior circulation, was associated with classic symptom presentation. The findings emphasized the importance of considering stroke location when assessing symptom presentation and underscored the need for further research on sex-specific stroke presentations.

Reference: sciencedirect.com/science/article/abs/pii/S0735675723005181