Men And Women : Risk Factors And Pathophysiology, Epidemiology, Presentation, Treatment, And Outcomes

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In the world, stroke is the 3rd leading cause of death as well as leading long term disability cause as of 2012.1 In addition, according to the Centers of Disease Control and Prevention, 33% of potentially preventable deaths in the US between 2008 and 2010 is attributed to stroke.2 Notably, 60% of all stroke deaths are women.3 Current research indicates the existence of a difference between how women and men present with stroke, how they are treated in an acute setting, and how they respond to treatment methods. Said disparity is of vital importance, given that targeted sex-specific therapies will help lower costs and reduce the burden of disease in the population. Therefore, this review will examine the variations between
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The membrane ionic gradient is lost, leading to intracellular Na and Ca increases; subsequent glutamate release exacerbates Ca influx via NMDA and AMPA receptors. The resulting excitotoxicity leads to organelles and membranes degeneration and necrosis.7 In the ischemic penumbra, reduced blood flow alone is not capable of causing neuronal necrosis; rather, it is the adjacent ischemic core glutamate release that causes Ca influx via AMPA and NMDA receptors. This activates Ca-dependent enzymes such as apoptosis inducing caplain and caspases in the penumbra, leading to NO, arachidonic acid, and superoxide production that help cells die.7

In contrast, hemorrhagic strokes (13% of all strokes) are intracerebral or subarachnoid in nature, and occur due to ruptured vessels.4 Although hemorrhagic strokes are less common, they are more deadly to patients due to potential hydrocephalus, increased intracranial pressure, and blood vessel spasms.8,9 With regards to incidence, men are more likely to have ischemic strokes10, while women are at greater risk for subarachnoid hemorrhages.11 These strokes are typically preceded by chronic hypertension and vascular malformations, which eventually results in a ruptured aneurysm. In turn, blood accumulation
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