Sex differences in TIA Presentation and Frequency of DWI abnormalities on MRI (P1.080)

OBJECTIVE: To determine if a sex disparity exists in transient ischemic attack (TIA) presentation and diffusion-weighted imaging (DWI) abnormalities on brain MRI. BACKGROUND: There is limited data evaluating sex differences in TIA symptom presentation and DWI abnormalities. The objective of our study was to evaluate TIA presenting symptoms and results of brain MRI between men and women presenting to the emergency room. DESIGN/METHODS: Prospectively identified patients presenting to the Emory University Hospital Emergency Department from January 1, 2011 to July 31, 2013 with TIA symptoms who underwent brain MRI within 24 hours were eligible for this analysis. Baseline patient characteristics, diagnostic test results, and clinical outcome at 3 months were retrospectively collected. Symptoms at presentation, frequency of restricted diffusion on DWI and 3 month clinical outcomes were evaluated between sexes. RESULTS: Of 333 patients eligible for this analysis, 224 (67[percnt]) were women. Age, frequency of baseline stroke risk factors, and ABCD2 score were similar between groups. While both sexes had similar frequencies of presenting symptoms including unilateral weakness or speech disturbance (Women 45.5[percnt], Men 41.3[percnt]; p=0.48), women presenting with either of these symptoms were less likely than men to have restricted diffusion on DWI (Women 11.8[percnt], Men 26.7[percnt]; p=0.02). Overall, women were significantly less likely to have restricted diffusion on DWI than men (Women 12.5[percnt], Men 21.1[percnt]; p=0.04). At 90-day follow up, the risk of stroke was similar for women and men (Women 0.9[percnt], Men 2.8[percnt]; P=0.19). CONCLUSIONS: Women presenting with TIA symptoms are less likely than men to have restricted diffusion on DWI. Further studies are needed to determine the basis for this difference. Disclosure: Dr. Billow has nothing to disclose. Dr. Harmouche has nothing to disclose. Dr. Ross has nothing to disclose. Dr. Belagaje has nothing to disclose. Dr. Anderson has nothing to disclose. Dr. Rangaraju has nothing to disclose. Dr. Greene has nothing to disclose. Dr. MacDonald has nothing to disclose. Dr. Nahab has nothing to disclose.