Abstract
In longitudinal studies, women are more likely than men to be disabled after stroke.1,2 Age, comorbidity, premorbid functional status, stroke severity and subtype, and diagnostic and therapeutic biases are possible explanations for this sex difference in functional outcomes. Biologic reasons may also exist: levels of procoagulant factors such as plasminogen activator inhibitor and factor VII are higher in women than men.3 This sex disparity in stroke outcomes has been less consistently demonstrated among patients receiving thrombolysis,4–7 providing indirect evidence that thrombolysis nullifies this gender gap, although one study (a tertiary analysis of the Glycine Antagonist in Neuroprotection trial [GAIN]) suggested this is not always the case.8 In this issue of Neurology ®, the Canadian Alteplase for Stroke Effectiveness Study (CASES) provides more supportive …
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