Much of the higher case fatality in women is likely to be attributable to the fact that women tend to be older at the time of their stroke.4 Studies that have adjusted for age (as well as other characteristics) show that the sex difference in short-term mortality can actually reverse, with women having lower mortality after adjustment.72,73 A study of temporal trends (1950 2004) in the US Framingham Study found that age-adjusted 30-day fatality decreased sig- nificantly for men but not women.22 Non-US populations have also reported mixed results in terms of sex differences in stroke case fatality over time,69 which may be attributable to differ- ences in the time periods studied, underlying demographics, lack of age adjustment, and other factors. Case-fatality studies for IS have shown either no sex differences or higher rates in A study from the Netherlands that examined trends in IS 30-day case fatality for the period 1997 to 2005 showed that in all age-sex groups, the case fatality declined significantly; the largest decline for men was from 12.5% to 6.9% ( 0.42 change) in the 65- to 74-year-old age group, and the largest decline for women was from 6.4% to 3.5% ( 0.45) in the 35- to Data are limited to assess case fatality for hemorrhagic strokes. A study restricted to a younger popu- lation (20 44 years of age) reported lower 30-day case fatality after SAH in women than in men (9% versus 17%).41 Studies have shown differing patterns of ICH case fatality by sex. The Atherosclerosis Risk in Communities study (ARIC) reported a lower 30-day ICH case fatality for women than for men but the Northern Manhattan Stroke Study found slightly higher 1-month case fatality for women than men (40% versus 35%).41 Temporal trends in case fatality for hemorrhagic stroke are largely unreported. 