Stroke in Women

The National Commission on Macroeconomics and Health in India Projects about 1.6 million cases of stroke in India by 2015 with death occurring in one-fourth of the cases. Although,gender-wise data are not available for stroke in India, women have a higher incidence of stroke across the world. In the United States, stroke is the fifth leading cause of death in men, whereas it is the third leading cause of death in women. More than half of the new strokes occur in women and one out of every five women with stroke die.

In India, not only are the women less likely to receive medical care, they are also at increased risk of having a stroke because of the following reasons:

1. Pregnancy and High blood pressure: Women are more likely to have a stroke during pregnancy. High blood pressure during pregnancy also places the women at risk of having a stroke even after the pregnancy. Development of diabetes during pregnancy also increases the risk of stroke. Timely treatment of high blood pressure and diabetes during pregnancy helps to mitigate the risk.

2 Birth control pills:Oral birth control pills carry a higher risk of stroke, especially in combination with high blood pressure and smoking.

3 Hormone replacement therapy:Is known to increase the risk of stroke.

4:Is Stroke following child birth is more common in rural India than in the urban setting due to improper aseptic precautions during child birth and dehydration in the mother

5. Improper aseptic precautions during termination of pregnancyby quacks is again more common in rural India than in the urban setting. Infection following termination of pregnancy is a risk factor for stroke

6.Increased prevalence of brain aneurysms (causing brain bleed) in women

7.Women with Migraines associated with specific symptoms (aura) are associated with increased risk of stroke

9 Obesity is twice as common in women than in men in India

10. Lower level of education and awareness among women

Are the symptoms of stroke in women different?

In addition to the typical symptoms of stroke (facial droop, arm or leg weakness and difficulty in speech), women with stroke may experience the following symptoms

• sudden face and arm/leg pain
• sudden hiccups
• sudden nausea
• sudden general weakness
• sudden chest pain
• sudden shortness of breath
• sudden palpitations
• unresponsiveness
• disorientation
• confusion
• sudden behavioral change
• agitation

Having a stroke is one of the most devastating and 'life changing' event. Timely recognition of risk factors for stroke in women is very important so that appropriate steps can be taken to prevent its occurrence. The difference in symptoms of stroke in men and women should also be kept in mind. Finally, the term 'FASTER' should always be remembered in the event of a stroke

• F - Face droop
• A - Arm or leg weakness
• S - Speech difficulty
• T - Time from onset of symptoms
• E - Early - Seek medical advice immediately
• R - Restore - Restore blood supply to the brain

Predisposing conditions

• Infection
• Trauma
• Pregnancy, puerperium and birth control pill use
• Blood disorders that lead to increased tendency to form blood clots
• Bowel diseases such as Crohn's disease and Ulcerative colitis
• Cancer

Symptoms

• Sudden weakness or numbness of face, arm or leg; especially if the numbness is all on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden severe headache with no known cause
• New onset seizures

How is a venous stroke diagnosed?

CT or MRI scans are required to diagnose the stroke. They help to identify the location of stroke and its severity. Occasionally, a cerebral angiogram may be done to confirm the diagnosis. Blood tests may be required to identify the predisposing condition.

Treatment

ter. It is the mainstay of treatment in all the patients with venous stroke. In patients with very high pressure in the head, a surgery may be needed to remove a part of the skull. In rare cases, an angiogram and mechanical retrieval of the clot may be needed.

Outcome

In general, the outcome of venous stroke is better than that of arterial stroke if the stroke is treated on time and the predisposing condition is identified and treated. complete recovery is possible in up to 80% of the patients.