New National Survey Shows Most Women Don't Know Signs of Stroke

A new national survey reveals only 11 percent of women know the female-specific symptoms of stroke, a disease that kills twice as many women a year as breast cancer. Knowing the first signs of stroke is crucial because there's only a three-hour window to get help. But the survey, released by Ohio State's Wexner Medical Center, shows that most women can't identify their own unique risks and symptoms.

"What prompted the survey is that women in general receive less acute care for strokes and die more than men," said Dr. Diana Greene-Chandos, a neurologist and director of neuroscience critical care at Ohio State's Wexner Medical Center. "There is different symptomology between men and women. Stroke symptoms unique to women are that often get chest tightness, not pain, and they can get sent down the wrong pathway in the ER, because they may not realize they are weak on one side."

Other symptoms unique to women are a lightheaded, dizzy sensation and hiccups, oddly enough. These aren't the ones you can make go away; they are sudden and unrelenting, and bother the woman so much, she may not notice the other symptoms.

"Then the other thing is when women come in, they tend to get labeled with 'anxiety,' or tell the doctor 'My whole body is numb.' They are not good about being descriptive," said Greene-Chandos. "But the numbness is really only on one side, depending on which side of the brain is involved."

If you have any of these symptoms, be aware of what's happening with your body. If you're lightheaded, look in the mirror and make sure your face is not drooping. Put your arms in front of you and see if they are even. Speak and make sure you're able to understand. If these symptoms aren't there, it's unlikely it's a stroke. If you're unsure, go get it checked rather than risk it. Be sure to tell the intake desk that you think you may be having a stroke. Doctors only have three hours to give you the necessary medication to reverse it.

"TPA has been around for 15 years, but it's not a magic shot," said Dr. Greene-Chandos of this medication. "We've recently done a bit more in extending this time window, but you have to do a CAT scan, know exactly when the symptoms started and deliver it within three hours. Even in rural ERs, we have a robot camera to beam in and talk to doctors there, where we can see the patient and confirm whether they need the medicine."

TPA is a serious medication with the risk of bleeding, as it is meant to break up the blood clot. There is a one percent risk of severe or fatal reaction, and patients must be watched closely.

"If they get the medicine in time, however, they have a third greater chance to have minimal or no disability than a person who didn't. When it works, it's pretty marvelous," she said. "But sometimes with big strokes it won't work; the clot is too big, but we have the interventional ability to go in with a catheter and grab it. It's done from the inside of the blood vessel with an angiogram, like with a heart catheter. You inject dye and track it to the blockage, then pull it out with a special device that's slinky with a hook in the middle."

If you wait too long, stroke can cause loss of language, drooping of face or arms and legs, numbness on one side, loss of vision and true vertigo, which makes you feel like you are spinning relentlessly. Thankfully, most people do improve over time, but that varies on how young they are, how much rehab they've had and how healthy their brain is.

Women are 50 percent more likely than men to have depression after a stroke, because they're natural caregivers and having to be cared for can launch them into depression, and prohibit them from doing their best in rehab in the first few months, when it's most important.

Strokes can all get lumped together, but they are very different. The most common type is an ischemic stroke, when there is blockage inside the blood vessel blood and oxygen can't get to the brain. Depending on where this threat happens, you'll have a big or small stroke in that area, which will affect whatever controls movement in that area - the left side of the body, for example. An aneurysm, on the other hand, is a diseased blood vessel that starts to create a bubble that grows until it bursts. Some risk factors are similar, but this kind of bleeding stroke from aneurysm tends to be more severe.

Dr. Diana Greene-Chandos said women must pay attention to risk factors: high blood pressure, diabetes, smoking and obesity/lack of exercise. Women should also beware if they are on estrogen, because as a pro-coagulant, it can make blood more prone to clotting. Also, if you're on an oral contraceptive and smoke, you're at a higher risk for stroke.

"And if you're on the other end of the age spectrum and your physician wants to put you on hormone replacement therapy, this is another risk factor," said Greene-Chandos. "Other factors are having migraine headaches more than once a month, because blood pressure constricts, then dilates in a migraine. If you have lupus or inflammatory autoimmune diseases, which are more common in women, you have to be careful. Connective tissues diseases also put women at a higher risk for stroke, although we don't really understand why."

There is no silver bullet for preventing strokes, but because damage is cumulative, the doctor recommends that as soon as possible, women quit smoking, shift to a more plant-based diet, eat meat in moderation, keep close to a normal BMI and avoid abdominal obesity.

"Drinking to excess is terrible for your brain, but red wine will absolutely help when it comes to cardiovascular and brain vascular health," she added. "I also advise switching to a more Mediterranean diet in general; when people switch their numbers normalize and they tend to show less inflammatory problems. The first step is to manage your diet; it's important. Obesity is on the rise, and it's killing people."

So women, know the ways to prevent a stroke, and know the symptoms that are unique to women. If you feel like you may be having a stroke, DON'T DELAY! Get to the ER within that three-hour window. It could save your life.