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Hidden Stroke: You Might Feel Fine. But Brain MRI Will Show Otherwise

Stroke is, no doubt, a devastating experience, whether you’re the patient or someone close to you. It’s called the silent killer for fatal reasons. According to the Centers For Disease Control And Prevention, approximately 795,000 Americans have a stroke, and 140,000 die due to it every year. And around 87% is the ischemic type that is caused due to the blockage of blood flow to the brain. 

Stroke: The Silent Killer

Deprivation of blood flow to the brain leads to the destruction of cells. When a large number of cells die, the patient’s ability to communicate or move deteriorates.

Hidden or silent stroke - is a version of a stroke that is smaller than a traditional stroke and yet has a significant impact on memory - termed ‘Silent Strokes.'

Silent or Hidden strokes have common symptoms. And according to research for every one person who has a stroke with symptoms, about 14 have a silent stroke.

What is a Silent Stroke?

A silent or hidden stroke is when the blood flow is interrupted to those areas of the brain that have no vital functioning.

Most people don’t even know that they have had a stroke - let alone understand its cognitive impairments.

So, the big question is: If a stroke does not have any symptoms and is only visible in a Brain MRI or CT Scan, how do you know that you’ve had one, and what can you do about it?

While it’s not practical for everyone to have an MRI scan, particular risk factors person more susceptible to having a stroke should consider:

  • High Blood Pressure
  • High LDL cholesterol levels
  • Smoking
  • Diabetes
  • Obesity
  • Sedentary lifestyle
  • Arrhythmia

How to detect a Silent Stroke?

A silent stroke is deadlier than the regular one.


The fact that it’s not easy to detect the symptoms of a silent stroke makes it deadlier to apprehend. You can counter or diagnose it with radiographic imaging, like, an MRI.

There are subtle signs that you can look for, but to the untrained eye, in most cases, it is mistaken for signs of aging:

  • Problems balancing
  • Frequent falls
  • Urine leaks
  • Frequent mood changes
  • Decreased ability to think or concentrate

In most cases, if a doctor suspects a silent stroke, an MRI scan of the Brain or CT Scan is recommended. If the image shows white spots or lesions, then it means those are the areas where the brain cells have stopped functioning.

That’s how doctors know that the deadly disease has struck again.

Is the damage in a Silent Brain Stroke Reversible?

Unfortunately, there is no way to reverse the damage to the brain cells - it is permanent.

But, in some cases, the healthy cells of the brain compensate for the damaged cells and take over their functions.

When Should You See A Doctor?

Detecting a silent stroke beforehand is not possible. However, you can check with the typical symptoms to consult a doctor.

Even if you aren’t having a stroke but are at risk, then plan a visit to a specialist to develop a plan to reduce the risk of having a stroke.

When you see a doctor or specialist for a stroke, you may be prescribed a Brain MRI with contrast - to get a better picture of the internal abnormalities.

Brain MRI FAQs:

What is a Brain MRI?

A brain MRI is a painless, non-invasive outpatient procedure that provides detailed Brain and brain stem images. It is a radiation-free procedure that combines multiple photos to create a 3D picture of the internal structures of the brain.

A brain MRI is so capable that it can detect abnormalities in the pituitary gland or the brain stem that is not possible in CT scans or X-rays. Sometimes, a contrast agent or dye will be injected to visualize structural abnormalities that may otherwise be missed.

How to prepare for a Brain MRI?

When a specialist recommends a Brain MRI, you will need to go to a hospital or a radiology center for the procedure. The medical staff there will ask you a few questions about:

Metal implants like:

  • Brain aneurysm clips
  • Defibrillator or pacemaker
  • Particular types of heart valves
  • Vascular stents
  • Inner ear implants
  • Any shrapnel or metallic pieces embedded in the body
  • If you are pregnant or not
  • If you have any tattoos
  • Any allergy to iodine or gadolinium (contrasting dyes)
  • Any current medicines that you might be taking
  • History of kidney problems
  • History of diabetes

It is also essential to let the medical staff know if you are claustrophobic. You might need to take some sedatives or can opt for an Open MRI or Front Open MRI system that is open on two sides and is better suited for claustrophobic patients.

You will also be asked to leave your jewelry and valuables at home or have a family member come with you to take care of your items.

How Long Does A Brain MRI Take?

A brain MRI generally lasts between 30-60 minutes, depending on the movement of the patient. If a Brain MRI with contrast is required, then it may take a little more time (to administer the dye).

What Happens During The Brain MRI Scan?

Depending on whether you get an MRI in a traditional machine or a Front Open MRI machine, a plastic coil/cage will be placed around your head to reduce movement. At this time, you may be administered the contrast dye to see blood vessels and minute parts of the brain better.

There is a microphone built into the machine, and you will be able to communicate with the radiologist or technician easily. You can also ask your radiologist to play some music that you want to listen to or ask for earplugs - to reduce the noise created by the machine.

What Happens After The Scan?

Once the MRI scan of the brain is carried out, you can resume normal activities immediately.

If you had a sedative administered, then it is best to have a friend or relative take you home as it is not safe to drive or operate heavy machinery or drink alcohol 24 hours after taking it.

A Radiologist will interpret your MRI scans, and a report sent to the doctor who prescribed the scan to you.

What Happens If You Are Diagnosed With A Silent Stroke?

Once you get a Brain MRI scan, your scans will be evaluated and sent to your prescribing doctor. If any abnormalities are found, then you will be assessed for risk factors that contribute to blockage of the blood vessels like high blood pressure, diabetes, high cholesterol, and vascular weakness in the brain or other parts of the brain.

If a silent stroke has already occurred, then the patient is generally recommended the stroke prevention guidelines. But, if symptoms before a silent stroke are detected, then patients may be required to take blood thinners or medication to lower blood pressure or LDL cholesterol.

Can You Prevent a Silent Stroke?

Yes, you can.

While it is hard to detect a silent stroke and even harder to restore function to the parts of the brain, it affects - it is relatively easy to prevent it from happening.

Here are some ways you can prevent it:

  • Monitor Blood Pressure: High blood pressure is one of the leading causes of artery weakening, as the blood continuously pushes against the artery walls.
  • Exercise: Most doctors recommend a 30-minute workout routine five days a week to decrease the risk of having a silent stroke.
  • Reduce the Intake of Salt: The American Stroke Association recommends reducing sodium level intake to lower blood pressure and prevent strokes.
  • Monitor Weight: Most doctors prescribe a Mediterranean diet for patients who are at risk of a stroke. Maintaining weight and keeping an eye on BMI helps reduce blood pressure levels and the risk of diabetes.
  • Maintain Cholesterol Levels: By maintaining a proper dietary plan, you can cut down on the intake of high LDL cholesterol food items and consume more fruits, vegetables, and lean meat.
  • Stop Smoking and Drinking: The risk of having a stroke doubles in smokers as compared to non-smokers, while consuming more than two glasses of alcohol per day doubles the risk of having a stroke. It is best to stop smoking and reduce alcohol consumption to the least for patients at risk of having a stroke.
  • Monitor Medication: Keep track of the medications prescribed to you and the time for consumption. Seek help or guidance when managing medicines so that the right treatment process continues.
  • Monitor Related Conditions:
    • Diabetes: Diabetes and Strokes have the same causes, and so, managing a proper diet, exercising, and monitoring medications is an unbroken line of defense against the disease.
    • Atrial Fibrillation: If you suffer from atrial fibrillation or irregular heartbeat, then you need to be closely monitored by your doctor - as it is one of the leading causes for a stroke.

Bottom Line

A silent stroke might not have any telltale signs or symptoms, but it causes permanent damage to the brain.

Like a regular stroke, these hidden killers cut off the supply to a small area in the brain and damage the brain cells, thereby having a progressive effect on not only your brain’s health but also your physical and mental aptitude.

If you are concerned about silent strokes and if you are at risk or not, talk to your doctor and make the recommended changes to prevent them.