Silent Stroke


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.'

If you have had a stroke, but didn't realize it- that is called a silent stroke. Usually a silent stroke is noticed on a Brain CT or Brain MRI as an incidental finding.

 These imaging tests can easily distinguish past strokes from recent strokes.

Does it matter if you are told that you have had a silent stroke? What should you do? Panic? Get treatment for the stroke? See a stroke specialist? Go to rehab? Apply for disability? Being told that you have had a previous silent stroke certainty may sound like alarming news, but it is not cause for alarm. If you have had a silent stroke, that means that it is time for a new strategy for taking care of your health.

If you have had a silent stroke and have been able to manage without noticing any neurological problems - then there is good news and bad news.

Good News About Silent Strokes

The good news is that silent strokes are generally easily ignored because they are small. The even better news is that they are silent because they occur in regions of the brain that control functions that are also controlled by other areas of the brain.

 This duplicate brainpower is what allows some strokes to happen without any effects. The best news about silent strokes is that having come through a stroke without consequences indicates that you are in very good health. Usually, if your brain has been able to compensate for a small injury of the brain tissue, this means that you have a healthy, fit body and a healthy fit brain.

Bad News About Silent Strokes

Having had a silent stroke indicates that you either currently have or have had one or more of the risk factors of stroke. These risk factors include cerebrovascular disease, hypertension, heart disease, diabetes, high cholesterol, a blood clotting disorder, smoking or drug use. 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, you might begin to experience neurological symptoms if you have another stroke in the future. Recurring small strokes can suddenly cause serious symptoms, often due to the cumulative effect of damage to multiple areas of the brain- even if they are small areas. The compensation provided by duplicate brain supply of some functions may eventually ‘run out’ if several areas of the brain are damaged.

What Should You do if You Find Out That You Have Had a Silent Stroke?

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 regular doctor, it is time to get connected to a regular physician and to start taking care of your health. 

Is a Silent Stroke the Same as a Mini Stroke?

A silent stroke is not the same as a mini stroke. A mini stroke describes a transient ischemic attack, a TIA. This is a stroke that reverses and completely improves without any long-term brain damage. It is a warning, but it does not appear on a Brain MRI or Brain CT scan. 

A silent stroke, on the other hand, is permanent, despite the fact that it is unnoticeable.


Weiner, William J., Goetz, Christopher G, Neurology for the Non-Neurologist, Fifth Edition, Lippincott Wiliams& Winkins, 2004