What It Means if You Have a Silent Stroke

How Silent Strokes Are Found

A silent stroke is usually diagnosed by chance, either when a person is being examined for an unrelated condition or has mobility or neurologic (brain-related) problems that cannot be explained.

Imaging Tests

Imaging tests that can diagnose a silent stroke include:

• MRI or CT scan
• TCD (transcranial Doppler ultrasound)

Common Risk Factors

Common risk factors for a silent stroke include:

• Hypertension (high blood pressure)
• Heart disease
• Diabetes
• High cholesterol
• Smoking

How Common Are Silent Strokes?

Silent strokes are more common than classic strokes. According to the American Heart Association, between 8 and 11 million people in the United States experience a silent stroke each year. By age 80, one in four people will have had one or more silent strokes.

Do They Have Lasting Effects?

Silent strokes are characterized by a limited area of brain injury and the total (or near-total) absence of symptoms. Many people with a silent stroke will never know that they had one and may go through life without any notable symptoms or consequences. However, some may experience longer-term symptoms that they may not recognize as being stroke-related.

Silent Strokes vs. Mini Strokes (TIAs)

A silent stroke is not the same as a mini-stroke (transient ischemic attack, or TIA). A TIA is a brief stroke-like attack with symptoms that resolve within minutes to hours. Unlike a silent stroke, where there is permanent brain damage, a TIA may improve without any long-term brain damage.

What Should I Do?

If you have had a silent stroke, it is important to not only engage in treatments to aid with rehabilitation and recovery but also to make lifestyle changes to prevent a full-blown stroke in the future.

Rehabilitation and Recovery

Recovery from a silent stroke may involve multiple providers and treatments to get you functioning normally (or as normally) as possible following your diagnosis. This may include:

• Physical therapy to help you relearn motor and coordination skills
• Occupational therapy to help better manage daily activities
• Speech therapy to help overcome problems producing or understanding speech
• Strength training with a personal trainer or physical therapist to improve lower extremity weakness
• Memory games to help overcome cognitive impairment
• Psychotherapy to deal with depression, anxiety, or self-esteem issues

Prevention

It is important to take steps to prevent a future stroke, regardless of how long ago the silent stroke may have occurred. Tissue damage in the brain inherently weakens blood vessels or causes them to narrow, both of which can contribute to a stroke. This is true even if you’ve never experienced any symptoms and feel perfectly fine.

Preventive Treatments

Preventive treatments may involve:

• A healthy, Mediterranean diet
• Routine exercise
• Weight loss if overweight or obese
• Controlling blood sugar
• Quitting cigarettes
• Anticoagulants (blood thinners) to prevent clot formation
• Statin drugs to reduce high cholesterol levels

Summary

A silent stroke is one in which you have no notable symptoms and may not even realize that you had it. Even so, it can cause damage to the brain and potentially serious symptoms in later life, including an increased risk of dementia or a full-blown stroke. A silent stroke is often diagnosed by chance during a brain scan for an unrelated condition or symptoms you cannot explain. Once diagnosed, a silent stroke needs to be treated with lifestyle changes and medications to prevent a future stroke.