Stroke may present and progress differently in men and women, potentially affecting age at onset, comorbidities, neurological deficits, and acute interventions. Most research on sex differences comes from high-income countries and non-Hispanic populations, limiting generalizability. In Latin America, social, cultural, and healthcare system factors may contribute to disparities in stroke management and outcomes. Understanding potential gender-specific differences is essential to guide equitable care and improve outcomes in underrepresented populations.

We conducted a cross-sectional study of Hispanic patients admitted with de novo anterior ischemic stroke to a certified stroke center in Guayaquil, Ecuador. Demographics, comorbidities, neurological deficits at admission (hemianopsia, facial palsy, dysarthria, motor deficits, aphasia, dysphagia, gait abnormality, and dysmetria), acute interventions, and in-hospital outcomes were extracted from electronic records. Gender differences were assessed using t-tests for continuous variables and Chi-square tests for categorical variables.

A total of 564 patients were included (54.5% males). Females were older (73.9±12.5 vs. 69.7±12.5 years, p=0.01) and had higher rates of diabetes (54.1% vs. 42.0%, p=0.008) and hemianopsia (17.5% vs. 6.2%, p<0.001). Males more often received fibrinolytic therapy (5.9% vs. 0.0%, p<0.001) and mechanical ventilation (14.3% vs. 8.7%, p=0.011). No sex differences were seen for ICU admission (18.6% vs. 13.5%, p=0.08), in-hospital mortality (23.5% vs. 28.0%, p=0.29), or hospitalization length (12.9±12.1 vs. 11.6±10.8 days, p=0.23). Other neurological deficits at admission were similar (p>0.05).

In this Hispanic cohort, women were older and had higher rates of diabetes and hemianopsia, while men more frequently received acute interventions. Other clinical features and in-hospital outcomes were similar between sexes. These findings suggest potential gender-related differences in stroke management, highlighting the need for further studies to identify underlying factors and inform strategies that promote equitable care in Latin American populations.