• Mariam Ali, Ellis S van Etten, Saloua Akoudad, Joanna D Schaafsma, Marieke C Visser, Mahsoem Ali, Charlotte Cordonnier, Else Charlotte Sandset, KlijnCatharina J MCJMDepartment of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands., Ynte M Ruigrok, and WermerMarieke J HMJHDepartment of Neurology, University Medical Centre Groningen, Groningen, Netherlands..
• Department of Neurology, Leiden University Medical Centre, Leiden, Netherlands. Electronic address: m.ali@lumc.nl.
• Lancet Neurol. 2024 Jun 1; 23 (6): 625635625-635.

AbstractHaemorrhagic stroke is a severe condition with poor prognosis. Biological sex influences the risk factors, presentations, treatment, and patient outcomes of intracerebral haemorrhage, aneurysmal subarachnoid haemorrhage, and vascular malformations. Women are usually older at onset of intracerebral haemorrhage compared with men but have an increased risk of aneurysmal subarachnoid haemorrhage as they age. Female-specific factors such as pregnancy, eclampsia or pre-eclampsia, postmenopausal status, and hormone therapy influence a woman's long-term risk of haemorrhagic stroke. The presence of intracranial aneurysms, arteriovenous malformations, or cavernous malformations poses unique clinical dilemmas during pregnancy and delivery. In the absence of evidence-based guidelines for managing the low yet uncertain risk of haemorrhagic stroke during pregnancy and delivery in women with vascular malformations, multidisciplinary teams should carefully assess the risks and benefits of delivery methods for these patients. Health-care providers should recognise and address the challenges that women might have to confront when recovering from haemorrhagic stroke.Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.

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