The article provides a comprehensive review of sex differences in stroke, focusing on epidemiology, clinical presentation, medical care, and outcomes. Key points include: 1. **Epidemiology**: Stroke affects more women than men due to higher incidence rates in older age groups and longer life expectancy. Women have higher stroke mortality rates, particularly in older age groups. 2. **Clinical Characteristics**: Women often present with more severe disabilities and are more likely to live alone. They are also more likely to have atrial fibrillation and hypertension, while men are more likely to have a history of heart disease and diabetes. 3. **Prehospital and In-hospital Delays**: Women are less likely to receive timely interventions, such as intravenous alteplase, and experience longer delays in hospital care. 4. **Sex Differences in Acute Stroke Care**: Women are less likely to receive certain diagnostic and treatment procedures, such as brain imaging and lipid testing, and are less likely to undergo carotid endarterectomy. 5. **Functional Outcomes and Quality of Life**: Women have poorer functional outcomes, more physical impairments, and lower quality of life after stroke compared to men. They are also more likely to experience depression. 6. **Rehabilitation and Post-stroke Recovery**: Women are less likely to be discharged home and are more likely to be in long-term care. They do not recover as well from rehabilitation and have higher rates of post-stroke depression. 7. **Future Research**: The article recommends further research to understand the biological origins of sex differences in stroke, the effectiveness of exogenous hormones, and the development of sex-specific interventions to improve recovery and reduce disability in women. Overall, the review highlights the need for greater attention to sex differences in stroke care and outcomes to improve outcomes for women.The article provides a comprehensive review of sex differences in stroke, focusing on epidemiology, clinical presentation, medical care, and outcomes. Key points include: 1. **Epidemiology**: Stroke affects more women than men due to higher incidence rates in older age groups and longer life expectancy. Women have higher stroke mortality rates, particularly in older age groups. 2. **Clinical Characteristics**: Women often present with more severe disabilities and are more likely to live alone. They are also more likely to have atrial fibrillation and hypertension, while men are more likely to have a history of heart disease and diabetes. 3. **Prehospital and In-hospital Delays**: Women are less likely to receive timely interventions, such as intravenous alteplase, and experience longer delays in hospital care. 4. **Sex Differences in Acute Stroke Care**: Women are less likely to receive certain diagnostic and treatment procedures, such as brain imaging and lipid testing, and are less likely to undergo carotid endarterectomy. 5. **Functional Outcomes and Quality of Life**: Women have poorer functional outcomes, more physical impairments, and lower quality of life after stroke compared to men. They are also more likely to experience depression. 6. **Rehabilitation and Post-stroke Recovery**: Women are less likely to be discharged home and are more likely to be in long-term care. They do not recover as well from rehabilitation and have higher rates of post-stroke depression. 7. **Future Research**: The article recommends further research to understand the biological origins of sex differences in stroke, the effectiveness of exogenous hormones, and the development of sex-specific interventions to improve recovery and reduce disability in women. Overall, the review highlights the need for greater attention to sex differences in stroke care and outcomes to improve outcomes for women.