I am Dr. Sahil Kohli, consultant neurologist and stroke specialist in hospital in Gurgaon. I will be talking about stroke and women today. Stroke in women is a very very important topic because one in five females are going to have a stroke in their lifetime and 60% of all stroke deaths are in females. Stroke is the third leading cause of death in women and fifth in men and stroke kills twice as more women as compared to breast cancer. Still, the thought and the question of stoke in women is less represented. It is very important for women to identify and know about the risk factors for stroke and how they can prevent it. The traditional risk factors for stroke in women are the same as in men which are hypertension, diabetes, cigarette smoking, obesity and high cholesterol levels. Other than that there are specific risk factors in women which needs mention, these include the women in childbearing age group, in this period females who are on oral contraceptive pills especially who are on ethinyl estradiol pills they have a high incidence of strokes and these strokes are especially more common if the females are smoking and have other traditional risk factors.
The second point is pregnancy. The pregnancy is also a procoagulant state where there is a tendency of the blood to coagulate specially in the peripartum and the postpartum period where there is a special type of stroke called as a cerebral venous thrombosis which is very very common and any female who has new onset of headache or seizures during this period has to be evaluated for a CVT. And the third important thing is in the young age group is the female with migraine with aura. Migraine with Aura has a special connection with brain stroke. Females who have a migraine with aura and those who continue to smoke and have oral contraceptives have an additional risk factor and they should be counseled for taking care of their risk factors so that stroke can be prevented. The second stage is the period in the postmenopausal age group. In the postmenopausal age group, females especially who are on hormonal replacement therapy and the hormonal replacement therapy which has higher estradiol content, they have a higher tendency for stroke.
The third important thing is females who are more than 80 years, it has been seen that females who are more than 80 years of age they are less likely to receive good medical care especially in terms of treatment of hypertension, diabetes and anticoagulation for atrial fibrillation thus putting these females at a higher risk. It is important that stroke should be considered as a treatable emergency and it should be identified and correctly treated. For the identification of stroke, a powerful 4 letter word has been given by AIG which is F-A-S-T FAST. ‘F’ means the sudden onset of facial dropping, ‘A’ means sudden onset of arm weakness, ‘S’ is sudden onset of speech problems or slurring and ‘T’ is time. So time is very important which is 4.5 hours. So all the patients who develop certain these symptoms should be identified correctly and reach a hospital where the treatment can be given in the first 4.5 hours.