What is a silent stroke? Causes and prevention

  •   Fri, Oct 28 2022
  •   By Dr Rohit Pai

October 28, 2022

Stroke and Myocardial infarction are two major diseases globally. Stroke is a devastating neurological disease caused by disruption of blood supply to the brain, whereas Myocardial infarction is caused due to disruption of blood supply to the heart. Stroke is easily recognized by its symptoms like one-sided weakness of the body, facial deviation, and difficulty in speaking (slurring). Here the symptoms are overt. We have often come across the term ‘silent myocardial infarction’ or silent MI. Is there something called a silent stroke? When stroke ‘strikes’ the important areas of the brain of the brain it causes instantaneous symptoms. Silent strokes, like any other strokes, happen when the blood supply to the brain gets suddenly disrupted. The difference is that it affects those areas of the brain which do not have any visibility. Silent stroke is picked up on brain imaging techniques like MRI. They are seen as tiny dots, or as we call them, ischemic areas in the MRI.

Are silent strokes dangerous?

Our brain is made up of 100 billion neurons which are interconnected by synapses. All neurons are equally important and most have specific functions. All neurons work in tandem to execute various brain functions. However, the accumulation of multiple silent clots disrupts this beautiful tandem. It does not cause spontaneous symptoms, but when they keep on accumulating, it leads to a state called Binswanger’s state or multi-infarct state. This causes a type of dementia called vascular dementia. People with vascular dementia suffer from cognitive deficits. This may begin with difficulty in remembering things or in concentrating. As the clots accumulate, the person will face emotional issues like inappropriate laughing or crying. The person will develop difficulty in walking -- walking will be done in short steps. It can cause judgmental errors; people find it difficult to take appropriate decisions. It can also cause loss of bowel or bladder control.

What is unique about silent strokes?

Silent strokes are caused by the same factors which cause major or normal strokes. Important causes are as follows:

• Uncontrolled blood pressure
• Uncontrolled diabetes
• High cholesterol
• Multiple clots

Uncontrolled blood pressure or sugar level lead to a condition called lipohyalinosis, which is the narrowing of the tiny blood vessels. Multiple small clots may also spread to the brain due to cardiac conditions.

The damage done by these clots is permanent. The effects enumerated above are due to the accumulation of multiple clots. It is like a Systematic Investment Plan (SIP in the stock markets, where you get a lot of money in hand upon accumulating small amounts over several years). In a multi-infarct state, you get the effect of accumulated SIP of clots.

How can we prevent silent strokes?

We can prevent silent strokes through balanced diet and regular exercise. Strict control of blood pressure and sugar is equally important. Quitting smoking, and reducing intake of alcohol and salt will help in preventing silent strokes.

 

 
By Dr Rohit Pai
Dr Rohit Pai is a consultant neurologist at KMC Hospital.
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Comment on this article

  • Rita, Germany

    Tue, Nov 01 2022

    Rudolf R.Mumbai,one thing I forgot to mention.They told me it must be my dental infection must be the reason so adviced me to get dental service.

  • Rita, Germany

    Tue, Nov 01 2022

    Dear Dr.Rudolf R.Mumbai.I just tell you my story.My age is 77.Am a survivor of many problems .A type 1diabetic which was nt recognized early .turned to type 2in pension time.Had MA ca one side and selective lymph nodes removal exactly 10years later came again as retarded.had high BP..now under control but still every quartal I have to control these BP;and sugar .still under control .Weight is hardly under 60.Since had also HRS.before corona .It was all before corona.I dont think it is due to corona.Had till now three vaccination .without problems.My first op was in 89.Thank God ,its Gods grace I survived till now without any type of radiation or chemo.but with tablets that time for 5years after second op.

  • Rudolf Rodrigues, Mumbai

    Sun, Oct 30 2022

    Rita, Germany; I am not aware of your age; but to tell you many people from among our family and friends, otherwise relatively healthy, and young have suddenly collapsed and died due to abrupt development of blood clots in the brain or coronary arteries post taking the first shot of Covid (Experimental Use Vaccine)! Now one of the vaccine cos has voluntarily disclosed that it's vaccine does have a rare (generic term) ADR of a specific type of fatal clot formation called TTS! Please do your own research!

  • Rudolf Rodrigues, Mumbai

    Sun, Oct 30 2022

    Dr Kusuma Kumari Gunji MBBS DGO, Nellore Kodyadka; Doc, I assume your degrees are from some University in and around Manipal??

  • Rudolf Rodrigues, Mumbai

    Sun, Oct 30 2022

    Doc, in a country like ours, which stands at 107 in the global hunger list with rampant malnutrition your article only scratches the froth on top (the elite, who can afford such costly screening procedures for evidence based medical approach); it's better if we have a grounds up approach rather than........!!!

  • Daniel, Mangalore

    Sat, Oct 29 2022

    Recent increased in strokes, clots, cardiac arrests a covert war on US military and rest of the world by communist chinese and liberal, a modern name for communist, elite ? Exclusive testimony of Army Whistleblower LtCol Theresa Long MD (flight surgeon). Her testimony shows how the DOD, FDA and many other organizations are violating federal code and how the jabs are causing vaccine injuries to fighter pilots as well as their medical records are being falsified to cover up jab injuries. Injuries from brain tumors, cancer, and deadly heart conditions she shows how the jabs are injuring and grounding many young military pilots. Find out the dangers they are facing... A 32 minutes testimony video at following concerned doctors website... https://concerneddoctors.org/army-ltcol-theresa-long-md-full-testimony-09-17-22/

  • Rudolf Rodrigues, Mumbai

    Sat, Oct 29 2022

    Nice article doc, but no mention about mini strokes and the aura like feelings one can get before getting a major stroke! Also, the symptoms mentioned could be overlapping with multiple other problems like micro nutritional deficiencies like lack of thiamine, methylcobalamin, vitamin D, Werner Korsakoff syndrome; also the simple method of layman's diagnosis of stroke (F-A-S-T)! Some patients may present with dizziness, sudden onset of headache and vomiting which can miss a fast diagnosis! Also, what emergency medicines like blood thinners etc to be given without knowing whether it's an ischemic or occlusive stroke?? Latest data reveals that the Covid vaccine has a rare disorder of producing a special type of clot called TTS?

  • Daniel, Mangalore

    Sat, Oct 29 2022

    Good information. Are Myocardial infarction and Myocarditis same ? Following on youtube - Study from Japan: COVID-19 Vaccines Myocarditis Risk higher than originally thought.

  • Rita, Germany

    Sat, Oct 29 2022

    Thank you Doctor for these informative material.As I had a such one of late ,so called ischemic one still not recovered ,have problems to write and many more.But on the whole recovering.Hope it will help others to have a idea.to find out early.

  • Dr Kusuma Kumari Gunji MBBS DGO, Nellore Kodyadka

    Fri, Oct 28 2022

    Very good information


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