Are we missing silent strokes? Why routine brain checks are important

Marking World Brain Day, observed yesterday, Dr Sadique Pathan highlights the overlooked risks of silent strokes and explains why routine brain checks are essential for early detection and long-term brain health
Are we missing silent strokes? Why routine brain checks are important

Strokes are often thought of as sudden, severe events that bring immediate symptoms like weakness on one side of the body, slurred speech, or trouble seeing. However, there’s a type of stroke that doesn’t present with obvious signs—silent strokes. These strokes don’t cause any immediate or noticeable symptoms, but they still damage the brain. Despite their subtle nature, silent strokes can have a serious impact on our health over time. The challenge is that they often go unnoticed, leaving damage to accumulate without intervention. 

What is a silent stroke? And why are silent strokes so dangerous?

A silent stroke occurs when blood flow to a part of the brain is blocked, but unlike traditional strokes, it does not cause any immediate symptoms that a person might notice. The term “silent” refers to the fact that these strokes don’t present with the obvious signs associated with more severe strokes, like a sudden inability to move or speak. However, they still result in brain damage, even though the person may feel fine in the moment. Silent strokes often affect small areas of the brain that are not responsible for major motor functions or speech, which is why they don’t cause immediate physical symptoms. But even though you may not feel anything, the damage to the brain can accumulate and affect memory, thinking, and mood over time.

Silent strokes are particularly dangerous because their effects are not immediately visible, yet they can cause significant brain damage over time. These strokes result in small, lasting damage to brain cells, which may not be noticeable initially but can accumulate with repeated strokes, leading to memory, concentration, and decision-making issues. Silent strokes also serve as warning signs for future, larger strokes, which carry a higher risk of causing severe disabilities like paralysis or speech loss. Furthermore, the damage from silent strokes can slowly impair cognitive functions, potentially contributing to memory problems, cognitive decline, and conditions such as dementia, often without the person realising it. Additionally, silent strokes can affect emotional health, leading to mood disorders like depression and anxiety, and these changes may go unnoticed, making early diagnosis and treatment more challenging.

Why are silent strokes often missed?

A silent stroke occurs when blood flow to a part of the brain is blocked, but unlike traditional strokes, it does not cause any immediate symptoms that a person might notice. The term “silent” refers to the fact that these strokes don’t present with the obvious signs associated with more severe strokes, like a sudden inability to move or speak. However, they still result in brain damage, even though the person may feel fine in the moment. Silent strokes often affect small areas of the brain that are not responsible for major motor functions or speech, which is why they don’t cause immediate physical symptoms. But even though you may not feel anything, the damage to the brain can accumulate and affect memory, thinking, and mood over time.

Role of routine brain checks – Regular brain assessments, with MRIs being the most common, play an essential role in spotting silent strokes at the earliest stages, often before the person knows anything is wrong. Catching these small lesions early means we can step in right away to tighten control of high blood pressure, diabetes, and cholesterol, helping to guard the brain from more damage and lowering the odds of a bigger stroke later on. For anyone who has already had a silent stroke, ongoing check-ups are equally important; they track memory and thinking skills closely, so any early hints of decline can be addressed quickly, giving us a chance to slow the progression of cognitive problems. Additionally, silent strokes can affect mood and emotions, and regular brain checks offer an opportunity to address mental health concerns like depression or anxiety, ensuring that individuals receive the support they need before these issues become more severe.

Who should get routine brain checks?

Certain individuals are more likely to experience silent strokes and should consider routine brain checks:

  • Older adults (Above 50 years): Aging increases the risk of silent strokes, as the brain becomes more susceptible to damage over time.
  • People with high blood pressure: High blood pressure is a leading cause of both silent and major strokes.
  • Diabetics: Diabetes can cause poor circulation, increasing the likelihood of stroke.
  • Those with high cholesterol: High cholesterol levels can lead to blocked blood vessels, raising stroke risk.
  • People with a family history of stroke or dementia: Genetics can play a role in stroke risk and cognitive decline.
  • Smokers or heavy drinkers: Smoking and excessive drinking can both increase the chances of stroke.
brain health screeningearly stroke detectionroutine brain checkssilent stroke awarenessWorld Brain Day 2025
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