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

Enduring a stroke is, without question, a devastating experience whether it directly affects you or someone you love. It’s called the silent killer because it can often prove to be fatal. According to the Centers For Disease Control And Prevention, approximately 795,000 Americans experience a stroke annually, leading to 140,000 fatalities. 87% are due to ischemia, resulting in 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 type that is smaller than a traditional stroke but can have a significant impact on memory.

Silent or hidden strokes have common symptoms. Research indicates that 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 occurs 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.

Therefore, 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 making a person more susceptible to having a stroke can include:

  • 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 standard type.


The difficulty involved in determining the symptoms of a silent stroke often makes it a deadlier type. However, you can counter or diagnose this difficulty with radiographic imaging methods like an MRI.

There are subtle signs that you can look for (and it's important to not mistake these for standard 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. White spots or lesions on the image represent areas where the brain cells have stopped functioning.

This is how doctors are able to identify when the deadly disease has occurred.

Is the Damage from a Silent Brain Stroke Reversible?

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

In some cases, however, 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 and should consult a doctor and monitor typical symptoms.

When you see a doctor or specialist for a stroke, you may be prescribed a Brain MRI with contrast to produce a better picture of any 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 images to create a 3D picture of the internal structures of the brain.

A brain MRI is capable of detecting abnormalities in the pituitary gland or the brain stem that are not possible via 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 visit a hospital or a radiology center for the procedure. The medical staff there will ask you a few questions. Such questions may include whether or not you have (or have ever experienced):

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, as you may require a sedative for the procedure. Alternatively, you can opt for an Open MRI or Front Open MRI system that is open on both ends 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 Procedure Last?

A brain MRI generally lasts between 30-60 minutes, depending on the movement of the patient. If a Brain MRI with contrast is required, it may take additional 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 better enhance images of the blood vessels and minute parts of the brain.

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

What Happens After The Scan?

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

If you had a sedative administered, you will need to have a friend or relative transport you home, as it is not safe to drive or operate heavy machinery or drink alcohol 24 hours afterward.

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

What Happens If You Are Diagnosed With A Silent Stroke?

Once you undergo a Brain MRI scan, the images will be evaluated and sent to your prescribing doctor. If any abnormalities are found, you will be assessed for risk factors that can contribute to blockage of the blood vessels. These can include high blood pressure, diabetes, high cholesterol, and vascular weakness in the brain.

If a silent stroke has already occurred, the patient is generally recommended to follow standard stroke prevention guidelines. However, if symptoms are detected in advance, patients may be required to take blood thinners or medication that lowers blood pressure/LDL cholesterol.

Can You Prevent a Silent Stroke?

Yes, absolutely.

While it is hard to detect a silent stroke and even harder to restore function to the parts of the brain it impacts, prevention is possible.

Here are some ways you can prevent stroke:

  • 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 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. 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 for all patients at risk of having a stroke.
  • Monitor Medication: Keep track of the medications prescribed to you and when they should be administered. 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. Managing a proper diet, exercising, and monitoring medications is a proven line of defense against the disease.
    • Atrial Fibrillation: If you suffer from atrial fibrillation or irregular heartbeat, you need to be closely monitored by your doctor, as this is one of the leading causes of stroke.

Bottom Line

A silent stroke might not have any visible signs or symptoms, but it can cause 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 its cells, thereby resulting in a degenerative effect on your brain’s health as well as your physical and mental aptitude.

If you are concerned about silent strokes – regardless of whether or not you are at significant risk – talk to your doctor and make the recommended changes for prevention.