The Difference Between Silent and Mini-Stroke

Although they sound similar, there is a difference between silent stroke and mini-stroke. First, though, let's talk about stroke in general. 

Stroke is a health emergency that occurs when blood supply to a part of the brain is reduced or interrupted. When that happens, the affected area can't get the blood, oxygen, and nutrients it needs, so the brain cells die.

The brain is an extremely complex organ that controls various body functions. If a stroke occurs and blood flow can't reach the region that controls a particular body function, that function won't work as it should. 

A stroke can involve the arteries leading to and within the brain. It is the fifth most common cause of death and a leading cause of disability in the United States.

Older couple walking
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Stroke Risk Factors

Risk factors for stroke include:

  • Age: The chance of having a stroke approximately doubles for each decade of life after age 55. While stroke is common among the elderly, a lot of people under 65 also have strokes.
  • Heredity (family history): Your stroke risk may be greater if a parent, grandparent, sister, or brother has had a stroke. 
  • Race: African-Americans have a much higher risk of death from a stroke than White people do. This is partly because Black people have higher risks of high blood pressure, diabetes, and obesity.
  • Sex: Each year, women have more strokes than men, and stroke kills more women than men. Use of birth control pills, pregnancy, a history of preeclampsia/eclampsia or gestational diabetes, oral contraceptive use, smoking, and post-menopausal hormone therapy may increase stroke risk for women. 
  • Prior stroke, mini-stroke, or heart attack: The risk of stroke for someone who has already had one is many times that of a person who has not. If you've had a heart attack, you're at a higher risk of having a stroke, too.
  • Other conditions: High cholesterol, high blood pressure, diabetes, and bleeding or blood clotting disorders are other risk factors for stroke.

Silent Strokes

A silent stroke is a stroke that someone has without realizing that it happened. Usually, a silent stroke is noticed incidentally on an MRI (magnetic resonance imaging) of the brain.

When patients are asked whether they remember having a stroke, they are often surprised and cannot recall feeling any symptoms of a stroke at any point in their lives. One study showed that by the age of 69, approximately 10% to 11% of people who consider themselves stroke-free have suffered at least one stroke that can be seen on MRI.

Silent strokes cause no obvious loss of function, because other areas of the brain are able to compensate for the damaged one. However, they are a strong risk factor for a more severe stroke later on.

Mini-Strokes

A mini-stroke, on the other hand, is a brief, but discrete and certainly memorable clinical event, in which a person develops the symptoms of a stroke for a few minutes to a few hours. By definition, the symptoms of a mini-stroke disappear in less than 24 hours. Mini-strokes are also referred to as transient ischemic attacks (TIAs).

TIAs are "warning strokes" that produce stroke-like symptoms but no lasting damage. TIAs are strong predictors of stroke. A person who's had one or more TIAs is almost 10 times more likely to have a stroke than someone of the same age and sex who hasn't. 

Recognizing and treating TIAs can reduce your risk of a major stroke. TIA should be considered a medical emergency and followed up immediately with a healthcare professional.

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Article Sources
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  1. Centers for Disease Control and Prevention. Leading causes of death. Last reviewed October 30, 2020.

  2. Centers for Disease Control and Prevention. Stroke risk. Reviewed January 17, 2017.

  3. Das RR, Seshadri S, Beiser AS, et al. Prevalence and correlates of silent cerebral infarcts in the Framingham offspring study. Stroke. 2008;39(11):2929-35. doi: 10.1161/STROKEAHA.108.516575

  4. American Stroke Association. TIA (Transient ischemic attack).