Walter Valesky, MD
Purroy F, Vicente-Pascual M, Arque G, Baraldes-Rovira M, Begue R, Gallego Y, Gil MI, Gil-Villar MP, Mauri G, Quilez A, et al. Sex-Related Differences in Clinical Features, Neuroimaging, and Long-Term Prognosis After Transient Ischemic Attack. Stroke. 2021;52:424–433.
Stroke affects more women than men. This gender preponderance has been attributed to longevity of women, putting them at higher risk of stroke. The gender differences are poorly reported in the literature for transient ischemic attack (TIA). The few studies that have addressed the gender differences in TIA have mainly focused on presentation nuances between men and women, initial management, and stroke recurrence rates of up to 1 year.1-2 Purroy et al. attempt to give greater insight into this issue by following a cohort of patients diagnosed with TIA for up to 10 years.
The authors analyzed data on 723 consecutive patients with TIA presenting to the emergency department after exclusion of mimics. These patients were admitted to the neurology service with a median ABCD2 score of 5. TIA was defined as transient neurologic deficits lasting less than 24 hours. Approximately 40% of these patients underwent imaging that was diffusion-weighted imaging (DWI) positive on MRI within 7 days of symptom onset. The diagnostic evaluation for stroke was notable in that extra- and intracranial ultrasound was utilized for vascular imaging rather than CTA or MRA. The primary outcome was recurrent ischemic stroke defined by new neurological symptoms associated with changes on neuroimaging.