What Are the First Signs of a Stroke in a Woman?

Reviewed on 4/28/2021

A stroke causes brain damage due to a lack of blood flow or oxygen when a blood vessel in the brain is blocked, leaks, or bursts. Signs and symptoms of a stroke can include numbness or weakness in the face, arm, or leg, usually only on one side of the body; trouble speaking or understanding speech, difficulty seeing in one or both eyes, problems walking, dizziness, loss of balance, or lack of coordination, and severe headache with no known cause.
A stroke causes brain damage due to a lack of blood flow or oxygen when a blood vessel in the brain is blocked, leaks, or bursts. Signs and symptoms of a stroke can include numbness or weakness in the face, arm, or leg, usually only on one side of the body; trouble speaking or understanding speech, difficulty seeing in one or both eyes, problems walking, dizziness, loss of balance, or lack of coordination, and severe headache with no known cause.

Stroke occurs when a part of the brain is damaged because a blood vessel in the brain is blocked, leaks, or bursts. When blood and oxygen do not reach parts of the brain, that part is damaged and does not function properly. 

Women are at higher risk for stroke than men. The lifetime risk of stroke for women between the ages of 55 and 75 in the U.S. is 1 in 5. Stroke kills twice as many women as breast cancer does, and it’s the third leading cause of death for women.

The three types of strokes include:

  • Ischemic stroke, the most common type of stroke, occurs when a blood vessel is blocked by a blood clot in the brain
  • Hemorrhagic stroke occurs when there is bleeding into the brain tissue
  • Transient ischemic attack (TIA), also called a “mini-stroke,” in which blood flow to the brain is blocked for a short time. It is often a warning sign of a future stroke.
  • Stroke is a medical emergency. If you or someone you know has any signs of a stroke, call 9-1-1 and get to a hospital’s emergency department immediately. 

Stroke signs occur suddenly. Five of the first signs of stroke in both women and men include:

  • Numbness or weakness in the face, arm, or leg, usually only on one side of the body
  • Trouble speaking or understanding speech
  • Difficulty seeing in one or both eyes
  • Problems walking, dizziness, loss of balance, or lack of coordination
  • Severe headache with no known cause

Additional signs of stroke in women include: 

The American Heart Association and the American Stroke Association suggest the word "FAST" as an easy way to remember signs of a stroke. Each letter in the word stands for important signs to look for and what to do about it:

  • Face – Does the person's face look uneven or droop on one side?
  • Arm – Does the person have weakness or numbness in one or both arms? Does one arm drift down if the person tries to hold both arms out?
  • Speech – Is the person having trouble speaking? Does his or her speech sound strange?
  • Time – If you notice any of these stroke signs, call for an ambulance (in the U.S. and Canada, dial 9-1-1) and get to a hospital immediately. You need to act FAST. The sooner treatment begins, the better the chances of recovery. 

What Causes Stroke?

Ischemic stroke occurs when a blood vessel is blocked by a blood clot in the brain. The main causes of ischemic strokes include:

Hardening of the arteries (atherosclerosis), which may be caused by:

Risk factors for ischemic stroke include:

Hemorrhagic stroke occurs when there is bleeding into the brain tissue. The main causes of hemorrhagic strokes include:

High blood pressure (hypertension). Factors that increase the risk of developing hypertension include:

  • Smoking
  • Sedentary lifestyle
  • Being overweight/obese
  • Excessive alcohol intake
  • Stress
  • Brain aneurysm, which is the rupture of a balloon or bulge in a blood vessel in the brain
  • Abnormally formed blood vessels in the brain

Risk factors for hemorrhagic stroke include:

  • High blood pressure
  • Smoking
  • Illegal drug use (especially cocaine and "crystal meth")
  • Use of blood thinners

Risk factors for stroke that are unique to women include: 

QUESTION

What is a stroke? See Answer

How Is Stroke Diagnosed?

Stroke is a medical emergency. If you or someone you know has any signs of stroke, call 9-1-1 and get to a hospital’s emergency department immediately. Most doctor’s offices are unable to perform the tests required to diagnose stroke, or the treatments needed to prevent or minimize brain damage.

In a hospital, testing for stroke includes:

What Is the Treatment for Stroke?

Treatment for stroke depends on the kind of stroke that is occurring. This is why it’s so important to get to a hospital quickly. 

Early treatment for ischemic stroke includes:

  • Thrombolytic therapy — medication called alteplase or "tPA" is administered intravenously (IV) to break up the clot blocking blood flow to the brain
  • Mechanical thrombectomy — involves placing a catheter in the blocked artery and removing the clot using a "stent retriever device" or suction to reopen the blocked artery
  • Antiplatelet medications such as aspirin
  • Blood thinners (anticoagulants) 

Long-term treatments to prevent recurrence of another ischemic stroke include:

  • Blood pressure medications
  • Cholesterol-lowering drugs
  • Antiplatelet therapy such as aspirin, clopidogrel, and the combination of aspirin plus extended-release dipyridamole and cilostazol 
  • Anticoagulants such as warfarin (Coumadin), Ddabigatran (Pradaxa), apixaban (Eliquis), edoxaban (Savaysa, Lixiana), and rivaroxaban (Xarelto)
  • Lifestyle changes 
  • Quitting smoking 
  • Avoiding or limiting alcohol intake
  • Eating a healthy diet, including a plant-based diet and low salt diet
  • Exercising regularly
  • Carotid artery revascularization to reestablish blood flow in a narrowing in the carotid artery

Treatment for hemorrhagic stroke includes:

  • Surgical treatment to prevent or stop bleeding or reduce the pressure inside the skull
  • Aneurysm treatment such as a clamp, coil embolization, or stents called flow diverters 
  • Arteriovenous malformation treatment that may include surgery, radiation to shrink blood vessels, or embolization techniques
  • Decompressive craniotomy 

Rehabilitation following a stroke may include: 

  • Physical therapy
  • Occupational therapy
  • Speech therapy 

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Reviewed on 4/28/2021
References
https://www.uptodate.com/contents/stroke-the-basics?search=signs%20of%20stroke&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

https://www.uptodate.com/contents/ischemic-stroke-treatment-beyond-the-basics?search=signs%20of%20stroke&topicRef=726&source=see_link

https://www.cdc.gov/stroke/about.htm

https://www.stroke.org/

https://www.nhs.uk/conditions/stroke/causes/

https://www.goredforwomen.org/en/about-heart-disease-in-women/signs-and-symptoms-in-women/symptoms-of-a-stroke

https://www.cdc.gov/stroke/women.htm