“Silent strokes are incidental
fi ndings. That means they are found when someone is having an MRI for another reason. Doctors order MRIs to fi nd the cause of headaches, dizziness, or a change in vision or cognition,” explains Russman. The American Heart Association
(AHA) explains that as MRIs have become more common, incidental fi ndings of silent strokes have increased. Silent strokes kill brain cells that
may show up as white spots (areas of scar tissue) on an MRI. “Silent strokes are also found when
we do an MRI to evaluate someone who has had a known stroke, and we fi nd evidence of previous stroke damage that caused no symptoms,” adds Noori. Silent strokes may be found on both
an MRI or CT scan, but MRI is the most sensitive imaging study for stroke damage. MRI may also be ordered to diagnose a patient with Parkinson’s disease, which is another way that silent strokes are found.
HOW DANGEROUS ARE THEY? If silent strokes are small or occur in less-functional areas of the brain, why do doctors worry about them? The main reason is that silent
strokes double your risk for a regular stroke, says the American Stroke Association. “Another reason is that the
damage from repeated silent strokes can accumulate over time and lead to a condition called vascular dementia,” says Noori. Vascular dementia is the most
common type of dementia after Alzheimer’s disease. Vascular dementia is caused by loss of blood supply to the brain. The main symptom is loss of
brain function, called cognitive decline. Memory problems that are greater than expected with normal aging are an early warning. Vascular dementia may start as
tiny, silent strokes in the internal part of the brain called white matter.
In people under age 55, silent strokes are very rare, but by age 70 or 80, they
may occur in 20 percent of people.” — Andrew Russman, D.O., neurologist at
“These strokes may occur in
the Cleveland Clinic Cerebrovascular Center “A mild blood thinner may be
blood vessels no bigger than a strand of hair,” explains Russman. “Over time they cause cognitive decline and vascular dementia. Because they occur in white matter, the damage is called leukoencephalopathy.” The work “leuko” come from
the Greek word for white or bright. Encephalopathy is the medical term for brain damage.
WHO IS AT RISK? According to Harvard Health, the risk factors are older age, atherosclerosis (fatty plaques in the arteries), atrial fi brillation (an irregular heartbeat), high cholesterol, high blood pressure, smoking, obesity, and lack of physical activity. The American Stroke Association
says that atrial fi brillation (AFib) is the most common cause of abnormal heart rhythm after age 65, and it doubles your risk for a silent stroke. Smoking also doubles the risk. Another risk factor is having a family history of stroke. “Many people have atrial fi brillation
and don’t know it, so in someone diagnosed with silent stroke, a doctor may do heart rhythm studies to rule out AFib. Another important test is to check the carotid arteries for atherosclerosis, since these are the main arteries going to the brain,” says Noori.
WHAT’S THE TREATMENT? The American Heart Association recommends that when silent strokes are found on an imaging study they should be treated to reduce the risk for a regular stroke by up to 80 percent. “Treatment starts by controlling the risk factors for stroke,” says Russman.
prescribed to reduce the risk of a blood clot. Controllable risk factors are ones like high blood pressure, diabetes, and cholesterol. They also include lifestyle changes like diet, exercise, and not smoking.”
WHAT CAN YOU DO? Let your doctor know if you have any symptoms that could be warning signs. “These could include clumsiness,
confused thinking, or problems with your memory. Don’t assume that these changes are due to old age,” says Noori. To prevent a silent stroke:
Work with your doctor to control high blood pressure, high cholesterol, or diabetes if you have those conditions. Limit salt in your diet to less than one teaspoon per day. Lose weight if you are overweight. Avoid saturated fat in red meat and added sugar in sweets or soft drinks. Eat lots of fruits and vegetables. Get at least 30 minutes of physical activity on at least fi ve days of the week. This can cut your risk of silent stroke by 40 percent. Don’t smoke. If you have trouble quitting, ask your doctor for help. “The fi nal and most important
message is not to ignore the signs of a stroke, even if they are mild,” says Russman. Stroke is a medical emergency
and requires emergency treatment to prevent permanent brain damage. The American Stroke Association
says, remember the acronym FAST ― the warning signs that you or a loved may be having a stroke: F for face drooping, A for arm weakness, S for speech diffi culty, and T for time to call 911.
OCTOBER 2021 | NEWSMAX MAXLIFE 83
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