Neurology Concepts: Young Women and Ischemic Stroke—Evaluation and Management in the Emergency Department

Wira, Charles; Miller, Joseph; Akhter, Murtaza; Barth, Bradley E.; Willey, Joshua Z.; Nentwich, Lauren M.; Madsen, Tracy E.

doi:10.1111/acem.13243

Cited by 11 publications

(5 citation statements)

References 107 publications

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“…Na literatura atual há muitos artigos que abordam o anticoncepcional como um fator de risco, mas não há evidências fortes de que seu uso prévio modificaria o prognóstico clínico de suas usuárias (Chang et al, 2017;Salisbury, Pfeffer, & Yip, 2011;Xu et al, 2018;Xu, Li, Tang, Huang, & Chen, 2015).…”

Section: Discussionunclassified

“…Para as mulheres em idade fértil, o uso de anticoncepcionais hormonais combinados contendo estrogênio e progesterona é um dos fatores de risco bem estabelecidos para a ocorrência de AVC (Champaloux et al, 2017;Poorthuis, Algra, Algra, Kappelle, & Klijn, 2017;Xu, Li, Tang, Huang, & Chen, 2015). Além do evento cerebrovascular, o uso deste medicamento pode aumentar o risco para outros eventos tromboembólicos, como, trombose venosa profunda, tromboembolismo pulmonar e infarto do miocárdio (Chang et al, 2017;Hugon-Rodin, Gompel, & Plu-Bureau, 2017;Xu et al, 2018).…”

Section: Introductionunclassified

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Quadro clínico de mulheres acometidas por acidente vascular cerebral em uso de anticoncepcionais hormonais

Batista

Lima

Oliveira‐Kumakura

2021

RSD

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Objetivo: investigar o quadro clínico de mulheres em uso de anticoncepcionais hormonais e que foram acometidas por acidente vascular cerebral (AVC). Método: revisão de escopo mediante estratégia de busca em quatro bases de dados (Pubmed, CINAHL, Scopus e Web of Science). Critérios de inclusão: estudos quantitativos ou qualitativos, estudos de revisão e literatura cinzenta, nos idiomas português, inglês ou espanhol nos últimos 10 anos. Excluíram-se editoriais e artigos que não respondiam à questão norteadora. Os dados foram apresentados na forma de tabelas e categorias de análise que permitiram sintetizar de forma narrativa os achados. Resultados: Identificados cinco estudos. Anticoncepcionais oral combinado, injetável combinado e de emergência foram os mais utilizados, mas nem sempre os artigos destacam a posologia, via de utilização e tempo de uso prévio. As pacientes foram avaliadas com uso de escalas e exame físico, da admissão até a reabilitação. A sobrevida das pacientes foi alta, mas a taxa de mortalidade e risco de recorrência eram elevados. Conclusão: o AVC em mulheres usuárias de anticoncepcionais foi tão grave quanto nas não usuárias, e aquelas que usaram o anticoncepcional por menor tempo apresentaram menor gravidade do AVC.

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Section: Discussionunclassified

Section: Introductionunclassified

Quadro clínico de mulheres acometidas por acidente vascular cerebral em uso de anticoncepcionais hormonais

Batista

Lima

Oliveira‐Kumakura

2021

RSD

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“…The literature has shown a large proportion of young patients with cerebellar infarctions at initial presentation have been misdiagnosed. 2 Cerebellar infarcts are rare in young adults, and extremely rare with bilateral and multiple cerebellar territories involvement. 3 Under the age of 35, the rates of cerebellar infarcts in general are only 0.002% per year.…”

Section: Descriptionmentioning

confidence: 99%

Mind the headache: rare bilateral cerebellar infarction in a young female patient

Kam

Rait

2021

BMJ Case Rep

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“…Male and female patients differ in their RFs for IS. Some modifiable RFs, such as oral contraceptive use, pregnancy, postpartum period, migraine with aura, and postmenopausal hormone replacement therapy, are female-specific [8]. On the other hand, most of the modifiable RFs are shared and occur in both male and female patients, but have a higher incidence in one of the sexes.…”

Section: Introductionmentioning

confidence: 99%

“…[6].The INTERSTROKE study proves the major role of the following RFs for IS: AH, DM, dyslipidemia, cardiac disease, current smoking, alcohol abuse, low physical activity and others [7].Male and female patients differ in their RFs for IS. Some modifiable RFs, such as oral contraceptive use, pregnancy, postpartum period, migraine with aura, and postmenopausal hormone replacement therapy, are female-specific [8]. On the other hand, most of the modifiable RFs are shared and occur in both male and female patients, but have a higher incidence in one of the sexes.…”

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confidence: 99%

Gender-Related Differences in Modifiable Risk Factors and Ischemic Stroke Subtype in Young and Middle-Aged Patients – A Prospective Study

Dimitrov¹,

Danovska²,

Marinova³

et al. 2023

JofIMAB

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Background: Male and female patients differ in their risk factors (RFs) and ischemic stroke (IS) subtype. A better understanding of the gender–related differences an important approach to successful prevention strategies for reducing the impact and burden of IS in young adults. Objective: To compare the gender–related differences in the prevalence of modifiable RFs and IS subtypes in young and middle-aged patients. Material and Methods: In the study were included 80 patients with acute IS, aged 18 – 59 years, admitted to the Neurology Clinic of UMHAT "Dr Georgi Stranski" Pleven. The following RFs were analyzed: arterial hypertension (AH), diabetes mellitus (DM), dyslipidemia, atrial fibrillation (AF), current smoking, number of cigarettes smoked per day, alcohol abuse, low physical activity, body overweight and chronic psychosocial stress. IS subtype was identified according to the Org 10172 Trial of Acute Stroke (TOAST). The statistical analysis was performed with the Statistical Package for Social Sciences, version 26.0 (SPSS). Results: Of all the 80 patients, 46 (57,5%) were males with a mean age 48,15±7,42 years, and 34 (42,5%) were females with a mean age 47,38±8,56. Male patients had higher rates of AH (80,4%), DM (47.8%), AF (4,3%), current smoking (73,9%), number of cigarettes smoked per day (60,9%), alcohol abuse (41,3%) and chronic psychosocial stress (52,2%), while the female ones showed higher rates of low physical activity (61,8%) and body overweight (38,2%). A statistical significance was found only for AH (p=0,004), DM (p=0,026), current smoking (p=0,007), number of cigarettes smoked per day (p=0,025) and alcohol abuse (p=0,031). The most common subtype of IS in males was large artery atherosclerosis (47,8%) and small vessel occlusion (28,3%). The female patients demonstrated a higher frequency of IS with other determined etiology (38,2%) and undetermined etiology (26,5%). Conclusion: Our data contribute to a better understanding of the gender–related differences of modifiable RFs and IS subtype in young and middle-aged patients with acute IS. The above findings definitely imply the necessity of developing additional specific therapeutic strategies for the effective control of modifiable RFs and lifestyle improvement in order to reduce the incidence of the most common subtypes of IS.

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Neurology Concepts: Young Women and Ischemic Stroke—Evaluation and Management in the Emergency Department

Abstract: Unique challenges exist in the evaluation and diagnosis of ischemic stroke in young women. There are still many opportunities for future research aimed at improving detection and treatment of this population.

Cited by 11 publications

References 107 publications

Quadro clínico de mulheres acometidas por acidente vascular cerebral em uso de anticoncepcionais hormonais

Quadro clínico de mulheres acometidas por acidente vascular cerebral em uso de anticoncepcionais hormonais

Mind the headache: rare bilateral cerebellar infarction in a young female patient

Gender-Related Differences in Modifiable Risk Factors and Ischemic Stroke Subtype in Young and Middle-Aged Patients – A Prospective Study

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