University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Handb Clin Neurol. 2020;175:299-312. doi: 10.1016/B978-0-444-64123-6.00021-7.
Sex disparities within the field of stroke, including subarachnoid hemorrhages (SAHs), have been in focus during the last 2 decades. It is clear that stroke incidence is higher in men, and also that men have their first stroke earlier than women. On the other hand, women have more severe strokes, mainly because cardioembolic strokes are more common in women. This leads to higher case fatality and worse functional outcome in women. It has often been pointed out that women more often have nontraditional stroke symptoms, and therefore may seek medical help later. After discharge from the hospital, female stroke survivors live alone in many cases and are dependent on external care. Therefore, these women frequently rate their quality of life (QoL) lower than men do. Female spouses more often provide help to their male stroke survivors than the reverse, and they accept a heavier burden. These caregivers are at high risk for depression, low QoL, and low psychologic wellbeing. SAH is a special form of stroke, often caused by a ruptured aneurysm. It is about 20% more common in women. The case fatality is high, but does not differ between the sexes.
在过去的 20 年中,中风领域(包括蛛网膜下腔出血[SAH])中的性别差异一直是关注的焦点。很明显,男性中风发病率更高,而且男性首次中风的年龄也比女性早。另一方面,女性中风更严重,主要是因为心源性脑栓塞在女性中更为常见。这导致女性的病死率更高,功能预后更差。人们经常指出,女性更常出现非典型性中风症状,因此可能会更晚寻求医疗帮助。出院后,许多女性中风幸存者独居,依赖外部护理。因此,这些女性经常比男性中风幸存者报告更低的生活质量(QoL)评分。女性配偶为其男性中风幸存者提供的帮助往往多于相反情况,而且她们承担的负担更重。这些照顾者患抑郁症、生活质量低和心理幸福感低的风险很高。SAH 是一种特殊类型的中风,通常由破裂的动脉瘤引起。女性发病率高约 20%。病死率虽高,但性别之间并无差异。