1% and 91.8%, respectively).

Interestingly Kleindorfer et al4 more information found that cases missed by FAST tended to be significantly younger than cases with FAST symptoms (mean 68.9 vs 71.5 years). Even though Kleindorfer et al investigate a general stroke population, in our selected cohort with younger patients (median age 46 years), we observed a comparable trend with significantly fewer patients presenting with symptoms covered by FAST in younger age groups. Therefore, clinical signs included in FAST might be less prevalent in younger patients with stroke. With respect to FAST signs there was no gender difference in stroke presentation. Other presenting symptoms such as headache, nausea/vomiting and somatosensory deficits occurred more frequently in women. This specific feature could not be explained by larger number of vertebra-basilar strokes in women. Gender differences in these symptoms were also significant when patients with TIA were excluded. In a previous study on gender differences in acute stroke symptoms a higher prevalence of symptoms termed ‘non-traditional’ (pain, mental status change, light-headedness, headache, non-neurological symptoms) could be registered in women.7 However, there were no differences observed regarding traditional symptoms such as hemiparesis, aphasia, facial weakness, hemibody numbness, which is in

line with our findings.7 Clinical signs clustered according to the FAST scheme disclosed more patients with stroke with increasing stroke severity. Nearly all cases who received thrombolysis irrespective of gender were indicated by symptoms included in FAST. This is of major interest, because a recent meta-analysis indicated that women with stroke had 30% lower odds of receiving tissue plasminogen activator thought possibly to result from different symptom presentation

in women. Hierarchy of presenting symptoms ‘Arm/paresis’ and ‘Speech’ are by far the most relevant ischaemic stroke signs. ‘Face’ can be quantitatively neglected, because it occurred as an isolated symptom very rarely. Nevertheless, 34.7% of patients with at least one FAST symptom report all three FAST symptoms, meaning that ‘Face’ is rare as an isolated symptom but often accompanied Drug_discovery by ‘Arm/Paresis’ or ‘Speech’. Similarly, headache is not relevant to identify ischaemic stroke but may characterise cases with subarachnoid haemorrhage. Remarkably, one single stroke sign (‘Arm/Paresis’) was effective enough to select 86.7% of patients in the subgroup of patients who underwent thrombolytic therapy. However, clinical signs included in the FAST scheme were absent in 23.5% of patients with stroke included in sifap1. Moreover 37.7% of patients with TIA had symptoms other than those mentioned by FAST. Sign included in the FAST scheme were also less frequent in young patients with vertebrobasilar infarctions (64.5%).