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The American Neurological Association held its 132nd Annual Meeting in Washington, DC, from October 7 to 10. Clinicians and scientists came together to share the latest research data in the field of neurology and neuroscience. Abstracts based on these presentations were published in a special supplement issue of the Annals of Neurology (registration required).
Women with ischemic strokes are known to have worse neurologic recovery than men, but the reasons for this have been unclear. Bushnell and colleagues evaluated comorbidities and disability in a prospective study of 133 women with ischemic stroke. They evaluated the initial stroke severity with the NIH Stroke Scale (NIHSS), and determined neurologic recovery with the modified Rankin Score (mRS) at 90 days after stroke onset. Comorbidity was assessed with the modified Charlson Index (stroke and hemiplegia excluded, but coronary heart disease [CHD] and diabetes included). CHD, but not Charlson Index, was the only clinical factor associated with the severity of stroke at presentation. The independent predictors of neurologic recovery were CHD (P = .002) and diabetes (P < .001). When CHD and diabetes were excluded, Charlson Index was the sole predictor of mRS (P < .0001).
This study indicates that women with CHD and diabetes who present with ischemic stroke have a high risk for long-term neurologic disability. These patients may benefit from the most aggressive and targeted post-stroke rehabilitation and support programs. In addition, vigilant monitoring and treatment of these comorbid conditions may be especially important for women at risk for stroke.
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