Sometimes, people may not realize they have had a stroke. This can happen with a silent cerebral infarction, or silent stroke, and transient ischemic attack (TIA). Silent strokes do not cause symptoms, and people often dismiss the symptoms of TIAs.

According to the American Heart Association, stroke is the fifth leading cause of death in the United States.

This article examines how it is possible for a person to experience a stroke without realizing it, how commonly this happens, and what the next steps are if a person thinks they have had a stroke.

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It is possible for someone to have a stroke without realizing it. These strokes are called silent cerebral infarctions, or silent strokes. They usually have no symptoms.

If symptoms do occur, the person experiencing them may often disregard them. This is because the symptoms do not last very long and are not usually obvious symptoms of a stroke.

People can also experience a transient ischemic attack (TIA), also known as a ministroke or warning stroke. Symptoms of a TIA often last only minutes to hours, so people may dismiss the symptoms, not realizing that they are experiencing a warning stroke.

According to the American Heart Association, around 25% of people over the age of 80 will experience one or more silent strokes. For every stroke with obvious symptoms, 10 silent strokes happen.

TIAs develop before approximately 15% of strokes.

Silent strokes typically have no symptoms and only show up on brain scans after the fact.

When symptoms do occur, they are usually subtle. For example, a person may develop imbalance or clumsiness that only lasts for a few days.

Symptoms of a TIA are the same as those of a full stroke, but they do not last very long. Symptoms include:

  • weakness or numbness on one side of the body
  • slurred speech
  • vision changes in one or both eyes
  • dizziness
  • severe headache

If a person suspects they have had a silent stroke or TIA, they should contact a doctor as soon as possible.

Having a silent stroke is a risk factor for future strokes and a sign of progressive brain damage. Brain damage can impair certain daily functions, such as speech and memory.

TIAs are a warning sign that a person will experience a full stroke. Approximately 1 out of 3 people who have a TIA go on to experience a stroke within 1 year.

A silent stroke is a type of stroke usually discovered incidentally on brain scans.

This means a person may have a CT or MRI scan for an unrelated reason, but the doctors notice white spots on the scan, known as white matter hyperintensities, where damage to the brain has occurred.

To diagnose a TIA, a healthcare professional will perform an initial assessment. They will ask the person about their symptoms and how long they lasted.

If the healthcare professional suspects the person has had a TIA, they will send them to a specialist. The specialist can perform a variety of tests to confirm a TIA diagnosis or rule out other causes.

If a person’s brain scans show evidence that they have had a silent stroke, a doctor may prescribe medications to reduce the person’s risk of having a stroke in the future. This can include blood thinning medications.

Treatment for TIAs involves lifestyle strategies, medications, and in some cases, surgery.

A doctor may advise a person to:

  • eat a balanced diet
  • exercise
  • stop smoking, if applicable
  • reduce their alcohol intake, if applicable

A doctor may also prescribe medication, such as:

If surgery is necessary, a surgeon may perform an endarterectomy. This procedure removes the lining of the carotid arteries.

There is nothing a person can do to definitively prevent a stroke from happening. Some people have higher risk factors than others. For example, unmanaged high blood pressure, high blood cholesterol, and heart disease can all increase a person’s risk of stroke.

However, there are several things a person can do to lower their risk of having a stroke.

These include:

  • quitting smoking, if applicable, and avoiding secondhand smoke whenever possible
  • reaching and maintaining a moderate weight
  • managing blood sugar levels if the person has diabetes
  • taking blood pressure medications if required
  • avoiding foods with added sugars and salt
  • getting physical exercise
  • limiting saturated fat and trans fat in the diet
  • attending regular medical checkups

It is possible for people to have a stroke without realizing it. This can happen if they experience a silent stroke. Silent strokes do not cause symptoms.

A person may also experience a TIA without realizing it. This is because the symptoms may not last long, and a person may disregard them.

If a person thinks they have had a stroke, they should contact a medical professional as soon as possible.