What It Means If You Have a Silent Stroke

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A stroke is such a significant event that it is hard to believe that some strokes actually go completely unnoticed. In fact, many patients can be completely caught off guard and are shocked to learn that they have been living with an 'old stroke' that did not cause any handicap at all, which is referred to as a silent stroke.

Usually, a silent stroke is noticed unexpectedly on a brain CT or brain MRI. These imaging tests can easily distinguish past strokes from recent strokes.

Recent strokes will have certain features that you will not see if the stroke occurred in the past, such as swelling, inflammation, blood clots, and bleeding. Also, older strokes have certain characteristic appearances caused by calcification (calcium deposits) and atrophy (tissue death).

What to Do

Being told that you have had a previous silent stroke certainty sounds alarming, but, in truth, it is not a cause for alarm. If you have had a silent stroke, this simply means that you need a new strategy to improve your cardiovascular health and reduce the risk of future strokes.

However, if you have had a silent stroke and have been able to manage without any overt neurological symptoms, you shouldn't necessarily assume that there is "less" to worry about. Here are some things that you should know:

Good News

The good news is that silent strokes are generally less impactful because they occur where other parts of the brain can compensate for any damage. In short, if a certain part of the brain is damaged, other adjacent neural pathways can "step in" and take over those functions.

More often than not, if you have been able to manage well after a small stroke, you are more likely to have a healthy, fit body and brain.

Generally speaking, people who are younger and physically fit often can often bounce back from a stroke with few to no symptoms or disability.

Bad News

Having had a silent stroke generally indicates that you have one or more of the risk factors of stroke. These include congenital risk factors (those that you are born with) and lifestyle risk factors (those that you can change or control).

Managing these risk factors through medication, diet, exercise, and stress control is important for your health.

Additionally, having had one or more silent strokes in the past tends to increase your risk of neurological symptoms if you have another stroke in the future.

Recurring small strokes can cause serious complications, such as vascular Parkinson's or vascular dementia, due to the cumulative damage to multiple areas of the brain. The compensation afforded by other parts of the brain will eventually "run out" if additional parts of the brain are damaged.

Silent Stroke vs. Mini-Stroke

A silent stroke is not the same as a mini-stroke. A mini-stroke describes a transient ischemic attack (TIA). A TIA is a stroke that causes noticeable symptoms that reverse and completely improve without any long-term brain damage. It is a warning, but it does not appear on a brain MRI or brain CT scan. 

Unlike a silent stroke, a TIA doesn't cause notable harm to the brain. With that said, a TIA is often predictive of future strokes and warrants the same preventive treatments used if a silent stroke is diagnosed.

A Word From Verywell

If your doctor has told you that you have had previous silent strokes, he or she will recommend screening tests to evaluate your risk factors. The next step is to control the risk factors, through actions such as taking heart or blood pressure medication, eating right, lowering cholesterol or managing salt in your diet, exercising, and cutting back on cigarettes or stress.

If you found out that you have had silent strokes in the emergency room, or from someone other than your regular doctor, you need to let your doctor know. Most importantly, if you do not currently have a doctor, it is time to get connected to a regular physician and to start taking care of your health.

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