Stroke in Women

Stroke is a major global health issue, ranking as the second-leading cause of death and the third-leading cause of disability. Unfortunately, even today, disparities in stroke diagnosis and treatment persist, particularly concerning ethnicity and gender. Women are disproportionately affected by stroke, often experiencing more adverse outcomes. In addition to the well-established stroke causes and risk factors, there are sex-specific stroke mechanisms to consider, such as hormonal contraception, pregnancy-related stroke, and menopause. This chapter delves into the comprehensive diagnostic process for ischaemic stroke, covering various neuroimaging techniques and their applicability, with a specific focus on addressing the unique requirements of pregnant women. The treatment of acute ischemic stroke has seen significant advancements, with intravenous thrombolysis and mechanical thrombectomy now recognized as major milestones. We will provide detailed information on reperfusion therapies and discuss the challenges associated with stroke during pregnancy, emphasizing the necessity for evidence-based guidelines. After surviving a stroke, effective secondary prevention strategies are crucial to reduce the risk of recurrence. These strategies include antithrombotic therapy, lifestyle modifications, and physical activity. For women, managing stroke risk during pregnancy and the postpartum period presents unique challenges, compounded by the impact of post-stroke depression and the need for personalized rehabilitation programs. This text offers a comprehensive exploration of the ischaemic stroke domain, covering its clinical characteristics, epidemiology, risk factors, diagnostic processes, acute treatments, and secondary prevention. Throughout, we emphasize addressing the distinctive considerations that women face, particularly during pregnancy and the postpartum period.