can you have a stroke and not know it
Healthy Living

Can You Have a Stroke and Not Know It?

May 30 2024

You may or may not have heard the acronym “BEFAST” for identifying a stroke. But can you have a stroke and not know it?

In short, yes. These types of strokes are called “silent strokes” because, unlike major strokes, the symptoms may not be obvious.

What is a silent stroke, and why can it go unnoticed?

A silent stroke refers to a stroke that doesn’t cause any noticeable symptoms. Silent strokes are often missed or misdiagnosed for several reasons.

There are little or no obvious symptoms

Silent strokes often do not exhibit the dramatic symptoms that are usually associated with a stroke, such as sudden weakness in the limbs, slurred or difficulty speaking, or severe headaches. Instead, you may experience very subtle changes, such as mild memory issues or problems with coordination.

Only small areas of the brain are affected

Silent strokes typically involve smaller areas of the brain – which may or may not control critical functions such as speech or movement, making them less noticeable.

There is a gradual onset of symptoms

In some instances, symptoms of a stroke may occur over time and not be recognized right away as a stroke, such as gradual weakness or numbness or gradual decline of mental ability.

The person experiencing a silent stroke has other health conditions

People with a history of high blood pressure, diabetes or atrial fibrillation (Afib) are often at a higher risk for stroke. However, because of this, they may attribute certain changes in their health to their known conditions rather than a stroke.

Despite being called “silent strokes,” these types of strokes are far from harmless. Often, symptoms can accumulate over time, causing significant brain damage and increasing the risk for another more severe stroke down the line.

How to know if you had a silent stroke

Silent strokes are often detected during brain imaging, such as MRI or CT scans, and usually for something unrelated to the actual stroke event. These types of imaging techniques allow specialists to see areas of the brain that may have been damaged by previous strokes.

Causes and risk factors

The causes of silent strokes are similar to those of other types of strokes. They include:

  • Hypertension (high blood pressure): This is the most significant risk factor. Chronic high blood pressure can damage blood vessels, making them more likely to clog or burst.
  • Atherosclerosis: The buildup of plaque in arteries can restrict blood flow to the brain.
  • Diabetes: This condition can damage blood vessels and contribute to atherosclerosis.
  • Cardiac conditions: Atrial fibrillation and other heart conditions can lead to the formation of blood clots that travel to the brain.
  • Lifestyle factors: Smoking, excessive alcohol consumption, poor diet and lack of physical activity increase the risk.

Why silent strokes matter

The cumulative effect of silent strokes can be substantial. Repeated incidents can lead to significant brain damage, increasing the risk of:

  • Dementia: Silent strokes are a known risk factor for vascular dementia, a condition caused by reduced blood flow to the brain.
  • Severe stroke: Individuals who have had silent strokes are at higher risk for having a more significant, symptomatic stroke in the future.
  • Mobility issues: Even without immediate symptoms, brain damage from silent strokes can affect motor skills over time.

Since silent strokes don’t present with dramatic symptoms, they can go unnoticed. However, even if you only suffer from one, they still cause damage to brain tissue, which can accumulate over time and lead to:

  • Cognitive decline: Memory problems, difficulty concentrating and other cognitive issues can develop gradually.
  • Physical symptoms: Minor physical changes such as weakness or clumsiness in limbs may be attributed to other causes if not properly investigated.
  • Mood changes: Some people may experience depression or mood swings.

How can you prevent silent strokes?

Preventing silent strokes involves addressing the same risk factors associated with all strokes. Key preventive measures include:

  • Blood pressure management: Regular monitoring and control of hypertension through lifestyle changes and medications if necessary.
  • Healthy diet: A diet rich in fruits, vegetables, whole grains and lean proteins can help reduce stroke risk.
  • Regular exercise: Physical activity helps maintain a healthy weight and lowers blood pressure.
  • Smoking cessation: Quitting smoking reduces the risk of stroke and improves overall cardiovascular health.
  • Managing chronic conditions: Effective management of diabetes, high cholesterol and heart conditions is crucial.

For those who have experienced a silent stroke, ongoing medical follow-up is essential. Doctors may recommend medications like antiplatelets or anticoagulants to reduce the risk of future strokes. Regular check-ups and lifestyle modifications play a critical role in managing health and preventing further brain damage.

How we can help

If you suspect that you may have had a silent stroke, your health care provider may recommend further testing and preventative measures to reduce the risk of having another stroke in the future. Regular health visits, controlling risk factors and leading a healthy lifestyle through diet and exercise are all ways to prevent silent and major strokes.

Want to learn more about your own stroke risk? Take our online stroke risk assessment for our Lima and Springfield markets today.

Also, learn about the stroke care services we provide at Mercy Health.

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