Silent strokes take a quiet toll

By Jamie Durant
Morning News Health/Environmental Reporter
Published: July 6, 2008

A new study found 10 percent of participants had previous damage from silent strokes, according to Stroke: Journal of the American Heart Association.

All the participants in the study were healthy, middle-aged people with no obvious stroke symptoms.

Dr. Christopher Cunningham, of McLeod Cardio-Thoracic and Vascular Associates in Florence, said it’s not outside the realm of possibility for this to be happening in people around the world.

“A stroke is an injury to the brain itself,” he said. “Lots of areas of the brain are very specific — lots of areas that, if you make small injuries there, the effects are more subtle.”

Cunningham said certain areas of the brain can withstand significant injury without presenting any obvious side effects, but it doesn’t make the injuries any less serious.

“Silent (strokes) are something that does occur,” he said. “But the real issue is that people who tend to have silent cerebral infractions tend to have clusters of them. They are at higher risk for future strokes and higher risk for developing dementia and Alzheimer’s-type diseases.”

Cunningham said the study gives people yet another reason to have regular medical check-ups, since the risk factors for silent strokes are the same as with typical strokes.

“It underscores the need for middle aged people to have the risk factors for cardiovascular disease really understood and managed beginning in middle age,” he said. “One of the things that’s coming out is that if you identify these risk factors at an early age, you can help prevent those big heart attacks and strokes.”

Dr. Joseph Healy, solo practicing neurologist in Florence at Carolinas Hospital System in Florence, said getting regular medical check-ups to determine risk factors for strokes is one of the most important things a person can do for themselves.

“The old adage is ‘an ounce of prevention is worth is a pound of cure,’ and it’s even more true today, because a pound of cure is expensive,” he said. “The cost of having a stroke is tremendous. There is a lot to be gained by being proactive.”

Healy said silent strokes left undiagnosed can continue to occur, causing massive damage to the brain.

“If you look at the brains of these people in an autopsy, it looks like Swiss cheese,” he said. “There’ll be these little holes and nobody even knows it happened.”

Healy said the result of those “little holes” can be dementia and multiple problems with motor functions such as walking, swallowing and balance, eventually leading to dementia.

“I think the bottom line is that you don’t have to wait to have a stroke to see what your risk are,” he said. “Look at your family history and see a doctor to get a good medical exam to see what your risks are and make sure you have addressed them.”

The study is the first of its type to compare risk factors with the prevalence of silent strokes.