Can You Have a Stroke and Not Know It?

When people hear the word ‘stroke,’ they typically think of a life-altering event that can dramatically impact one’s ability to speak, move, and engage with the world in general. Which is why millions of fully functioning Americans are increasingly surprised to learn they’ve had a stroke.

Called the ‘silent stroke,’ strokes without symptoms are 14x more common than those with symptoms. Some researchers estimate that more than a third of people over age 70 have had a silent stroke.

So how is it you can have a stroke and not know it?

To begin with, all strokes are caused by clots that block or interrupt the flow of blood. The severity of the stroke is determined by how much of and which part(s) of your brain is damaged by the blockage.

If the damage occurs in an area that controls essential functions, the resulting stroke will be quite obvious. But if the damage occurs in a small area that does not control essential functions, the stroke can go undetected even as it’s happening. Nonetheless, the damage caused is permanent.

Very often, the signs of a silent stroke are subtle and easily mistaken for naturally occurring signs of aging. Common symptoms include:

• Issues with memory 
• Trouble with balance, often leading to falls
• Changes in mood or personality
• Challenges thinking or holding onto thoughts

While a doctor may be able to recognize these subtle signs, a diagnosis can only be confirmed with imaging, such as a CT-Scan or MRI. Very often, silent strokes are discovered as result of imaging done for reasons completely unrelated to a suspected stroke.

However, if an individual suffers several silent strokes, the resulting damage can become evident to all. Recurring damage can impact speech, movement, and even lead to dementia.

While all strokes are unpredictable, they are largely preventable. In fact, the Centers for Disease Control and Prevention estimates that 80% of strokes are preventable.

Here’s what you can do to reduce your risk:

• Keep your blood pressure in check
• Quit smoking
• Maintain a healthy weight
• Eat a whole-food diet low in trans fats and high in fiber and vegetables
• Limit alcohol intake
• Exercise regularly
• If you have diabetes or atrial fibrillation, work with your doctor to keep it under control
• Be consistent with medications for heart disease, blood pressure, diabetes, and cholesterol

If you're experiencing signs of memory loss, or notice changes in a loved one, don't dismiss them as a normal part of aging. Schedule an appointment with your doctor to discuss what’s happening and to potentially prevent a stroke of any kind from occurring or recurring.

Adam Cohen, MD, is the director of Emergency Medicine and an Emergency Medicine physician at SVMC.