And while those tests appear to be under-used in all stroke patients no matter what their gender, the difference in testing between men and women may help explain why women tend to have a worse long-term outcome from stroke, including a higher death rate.

One in every seven people who has a stroke will have another one within a year. The study looked at the use of tests that can cut that risk, by assessing the potential for blood clots to form in the heart, and the health of the carotid arteries. The results of such tests can guide doctors to prescribe preventive treatment and help patients understand what they must do to prevent a second stroke.

"Diagnostic evaluations that should be done on every ischemic stroke patient still aren't being performed on a third to a half of patients, and they're less likely to be performed on women," says senior author Lewis Morgenstern, M.D., director of the Stroke Program in the U-M Cardiovascular Center. "Intervention is needed to increase access to quality stroke care for all patients, but especially women."

The new study is based on detailed analysis of records from a random sample of 381 patients, 220 of them female and half of them Mexican-American.

It found that women were 36 percent less likely than men to receive an echo-cardiogram of their heart, a test similar to pregnancy ultrasound that creates a movie of the heart and can looks for clot-producing conditions and other problems. Women were also 43 percent less likely to have exams of their carotid arteries, which can become narrowed by cholesterol plaque that blocks blood flow and spawns clots.; Source: University of Michigan Health System