What It Means If You Have a Silent Stroke

When most people think of a stroke, they think of a major life event that can completely change a person's ability to function. While this is often true, there are cases in which a stroke can go completely unnoticed. Many patients are caught off guard and shocked to learn they've had this type of stroke, called a "silent stroke," at some point in their life and experienced no handicap at all.

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

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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. Older strokes tend to have certain characteristic appearances caused by calcification (calcium deposits) and atrophy (tissue death).


Think FAST With a Stroke

What to Know

Being told you have previously had a silent stroke certainly sounds frightening but, in truth, it is not a cause for alarm. However, having a silent stroke and not experiencing any neurological symptoms does not necessarily mean you are in the clear.

If you have had a silent stroke, it's a strong signal that you need a new strategy to improve your cardiovascular health and reduce the risk of future strokes. Here are some important things to know about living with silent stroke.

Good News

The good news is that silent strokes are generally less impactful because they occur in places 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 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 and fit body and brain.

Generally speaking, people who are younger and physically fit often can 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. But 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 healthcare provider has told you that you have had previous silent strokes, they 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 healthcare provider, you need to let your healthcare provider know. Most importantly, if you do not currently have a healthcare provider, it is time to get connected to a regular healthcare provider and to start taking care of your health.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. Delgado P, Riba-Llena I, Tovar JL, et al. Prevalence and associated factors of silent brain infarcts in a Mediterranean cohort of hypertensives. Hypertension. 2014;64(3):658-63. doi:10.1161/HYPERTENSIONAHA.114.03563

  4. Blomstrand A, Blomstrand C, Ariai N, Bengtsson C, Björkelund C. Stroke incidence and association with risk factors in women: A 32-year follow-up of the Prospective Population Study of Women in Gothenburg. BMJ Open. 2014;4(10):e005173. doi:10.1136/bmjopen-2014-005173

  5. Blanco-Rojas L, Arboix A, Canovas D, Grau-Olivares M, Oliva Morera JC, Parra O. Cognitive profile in patients with a first-ever lacunar infarct with and without silent lacunes: A comparative study. BMC Neurol. 2013;13:203. doi:10.1186/1471-2377-13-203

  6. Fanning JP, Wong AA, Fraser JF. The epidemiology of silent brain infarction: A systematic review of population-based cohorts. BMC Med. 2014;12:119. doi:10.1186/s12916-014-0119-0

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By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.