What if you found out that there’s a condition affecting 8 to 10 million Americans every year—without them even knowing it? … A condition that quietly damages the brain and significantly increases the risk of severe strokes and dementia.
This condition is called Silent Stroke.
Typically, when someone has a stroke, the signs are alarming and obvious — sudden numbness on one side of the body, trouble talking, and, in the worst cases, loss of speech, comprehension, and even loss of consciousness. But, with a silent stroke, patients often experience very little to no symptoms at all. The damage happens quietly, over time, usually going unnoticed until it’s too late.
What is a Silent Stroke?
Most people associate strokes with sudden, noticeable symptoms—weakness on one side of the body, slurred speech, or confusion. A silent stroke, however, happens without any obvious signs.
Also known as a silent brain infarct (SBI), a silent stroke is a minor ischemic stroke that has no noticeable symptoms. These strokes often go unnoticed because they typically occur in smaller blood vessels in areas of the brain that don’t control functions like movement or speech. For many, the first time a person finds out they’ve had a silent stroke is when getting a brain scan for another issue.
In fact, for every stroke with traditional symptoms, there are an estimated 10 silent strokes that occur undetected.
Even without noticeable symptoms, silent strokes still damage brain tissue, increasing the risk of more serious strokes and problems with memory and coordination to come.
Who is at Risk for a Silent Stroke?
Silent strokes affect an estimated 8 to 10 million Americans annually, or about one in four people over the age of 80. And while older adults are at a higher risk, silent strokes are more common than you might think, impacting individuals across the demographic spectrum.
Does stroke run in your family? Having a genetic predisposition to stroke, such as a blood disorder or blood vessel disorder, can significantly increase one’s chances of experiencing silent stroke.
In addition, having a preexisting condition also increases the chances of having a silent stroke. For example, like traditional strokes, high blood pressure and diabetes contribute to over 50% of all silent strokes. To make matters worse, for people already managing these conditions, a stroke can further increase complications such as the risk of developing kidney disease, vascular dementia, heart failure, and more.
The highest risk for silent strokes has been identified in the following groups:
- Individuals with high blood pressure (hypertension)
- Individuals with diabetes
- Individuals with high cholesterol
- Children under 18 with SCD (sickle cell anemia)
- Individuals with atrial fibrillation (AFib)
- Post-menopausal women
- Chronic smokers
- Individuals with sleep apnea
- Individuals who have already had a stroke
Quiet Symptoms of Silent Stroke (Silent Brain Infarct)
Now you may be wondering… Are there really no signs?
Silent strokes are not a different type of stroke but rather strokes that go unnoticed because they don’t cause immediate, apparent symptoms.
And while we refer to them as silent strokes, they are more often overlooked or unnoticed episodes. The symptoms that come with silent stroke are not as pronounced as a traditional stroke and often mimic common symptoms of other conditions.
Men and women experience silent strokes differently. Women, especially postmenopausal women, may exhibit more subtle signs, such as fatigue, nausea, or sudden mood changes. Because these symptoms don’t fit the common stroke profile, they are often overlooked or mistaken for other conditions.
Similar to a mini-stroke (TIA), many patients report that they had relatively mild symptoms that go away quickly and, therefore, didn’t think too much of them. However, unlike a mini-stroke, silent strokes leave permanent damage. Even though TIAs may seem more concerning in the moment, silent strokes can be just as dangerous, increasing the risk of more severe strokes down the road.
| Symptom | Silent Stroke | Mini-Stroke (TIA) | Full Stroke |
| Noticeable immediate symptoms? | No | Yes | Yes |
| Temporary confusion | Yes | Yes | Rarely |
| Difficulty speaking | No | Sometimes | Yes |
| Lasting memory problems | Yes | No | Yes |
| Sudden numbness or weakness | No | Sometimes | Yes |
| Causes permanent brain damage? | Yes | No | Yes |
Symptoms that may indicate a silent stroke:
Cognitive & Mental Changes:
- Feelings of fatigue or confusion
- Mild memory issues (forgetfulness, trouble focusing)
- Mood swings or sudden agitation
Physical & Sensory Changes:
- Brief speech or vision changes
- Balance or coordination issues
- Feeling “off” without a clear reason
- Short-lived weakness or numbness
More Common in Women
- Sudden nausea, hiccups, or chest pain
- Shortness of breath or extreme exhaustion
What If I Think I Experienced a Silent Stroke?
An MRI or CT scan is the most reliable way to detect scar tissue from a silent stroke.
Whether it is a stroke or another condition causing your symptoms, don’t wait for more obvious symptoms. A proactive approach can help prevent more serious strokes and long-term complications.
So, if you think you may have experienced a silent stroke, see your neurologist right away. They can run brain imaging to confirm any damage and detect past damage. Your physician can also check you for high blood pressure, atrial fibrillation, diabetes, and other stroke risk factors.
Reduce Your Risk of a Silent Stroke
The good news? According to the American Heart Association, up to 80% of strokes can be prevented through education and lifestyle changes. The worst thing you can do is ignore the risks and do nothing!
It turns out that the same habits that protect your brain from stroke also promote overall well-being, improved cognitive function, and long-term health.
Small changes targeting stroke risk factors such as blood pressure, cholesterol, dehydration, and blood sugar can make a significant difference.
Staying physically active, quitting smoking, and keeping alcohol to a minimum are all good places to start. As always, eating a brain-healthy diet and taking steps to reduce stress, like mindfulness, better sleep, and breath work, are all important pieces of the puzzle.
When to See a Doctor
Silent strokes often go unnoticed until they accumulate, making more severe strokes more likely over time. Ignoring risk factors and even mild symptoms, especially for those in high-risk categories, can often lead to more severe strokes and rapid cognitive decline.
If you’ve noticed any changes or fall into a high-risk group, scheduling a screening or neurological check-up could help detect any hidden damage before it becomes more serious. Furthermore, your neurologist can help build a wellness plan that works for your unique condition and situation.
For more information on reducing risk factors and recommended lifestyle changes, feel free to visit the following Neurology Office resources below:
A Message From Dr. Kandel
“As I tell all of my patients, a good rule of thumb is, if you would have a loved ones seek medical attention for an issue, then it certainly would be reasonable for you to seek medical attention. Not attending to symptoms or putting off a comprehensive neurological evaluation can lead to much bigger problems down the road, and often times this is completely unnecessary. It is absolutely true. In this case, “an ounce of prevention is worth a pound of cure.”
Joseph Kandel, MD
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Neurology Office, Joseph Kandel M.D. and Associates
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