Information From Your Health Care Provider

STROKE, SILENT

Basic information

description

A silent stroke can occur when small blood vessels in the brain become blocked. It is called "silent" because there are none of the usual stroke symptoms (e.g., trouble walking, talking, or seeing, or paralysis or weakness on one side). Minor symptoms may not be noticeable. A person is not aware of having had a stroke. A silent stroke is detected only with a medical imaging test. However, silent strokes can cause real brain damage. They affect the brain areas involving mood, thinking, and personality. Silent strokes are common in older adults and more common than strokes with symptoms.

FREQUENT SIGNS & SYMPTOMS

Over time, subtle changes may develop in memory, thinking, concentration, or other cognitive effects.
Depression. It is more a feeling of apathy and a loss of interest in usual activities, rather than sadness.

causes

Silent stroke is a brain injury usually caused by a blood clot interrupting blood flow in the brain. A person still feels fine and doesn't even know it happened. Over time, the blood and oxygen supply to the brain decreases and cells die. This causes damage in the brain that can be seen on imaging tests.

risk increases with

Age 55 or older.
High blood pressure (hypertension).
Diabetes.
High cholesterol.
Heart disease (especially atrial fibrillation), or carotid and/or coronary artery disease, or previous transient ischemic attack (TIA or mini-stroke).
Smoking and/or excess alcohol use.
Obesity and/or sedentary (inactive) lifestyle.
Personal or family history of stroke or heart attack.
Use of birth control pills or other hormone therapy.

PREVENTIVE MEASURES

Get medical care for any treatable risk factors, such as high blood pressure.
Eat a healthy diet and exercise regularly.
Maintain a healthy weight.
Stop smoking. Avoid excess alcohol use.

expected outcomes

Many risk factors can be controlled to reduce the risk of stroke.

possible complications

Vascular dementia (mental decline due to disease of blood vessels in the brain).
Higher risk of having another stroke and/or dementia.

diagnosis & treatment

general measures

Brain damage due to a silent stroke is detected by an MRI of the brain. It is often an incidental finding. Incidental finding means the MRI was performed for another reason. There is no way to know from the MRI results just when a silent stroke occurred. Patients who have had a silent stroke typically have no memory of any specific stroke symptoms at any time in their lives. If you have a silent stroke detected, your health care provider will discuss the MRI test with you. Additional tests, medical follow up, and treatment will depend on your individual situation.
Very few patients will have a silent stroke detected. The MRI is not a routine screening test.
However, your health care provider can help determine your risk factors for a stroke and counsel you on ways to reduce your risks.
Reducing risks may include stopping smoking, diet changes, losing weight, exercising more, and limiting alcohol use. Be sure to follow any prescribed treatment for high blood pressure, high cholesterol, and diabetes. See your health care provider on a regular basis.

medications

Drugs may be prescribed to lower blood pressure, reduce cholesterol level, control diabetes, manage heart rhythm problems, or treat other medical disorders.
Blood thinners or drugs to help prevent blood clots (e.g., aspirin) may be prescribed for some patients.

activity

Try to get 30 minutes a day (or most days) of aerobic exercise, such as walking. Start with a few minutes a day and increase gradually.