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Health August 2012

Aid for Age

Stealth Strokes: ‘Silent’ and Deadly to Your Brain

By Tait Trussell

Researchers estimate that for every person who has a stroke with the usual signs of difficulty in movement or speech, there are 14 others who experience a silent stroke. A blood vessel has burst, cells have died. But the cells aren’t in a section of the brain that affects speaking or walking. The people don’t even know they have had anything happen.

Some seniors have 14 times more strokes than they are even aware of. Yet, over time, these stealth strokes can shrink your memory.

Usually, the signs of stroke are apparent — numbness or weakness on one side of your face, trouble walking and speaking. But the so-called “silent stroke” which normally is unnoticed is much more frequent, according to a report in the Harvard Women’s Health Watch.

Such hidden strokes are more common in women, but apparently only because women usually live longer than men.

With a typical stroke, a blood clot blocks a blood vessel feeding a portion of the brain. Cells in that area may die or malfunction. Then the brain sends signals that affect your ability to speak or walk.

A silent stroke, on the other hand, doesn’t affect parts of the brain that cause the typical stroke symptoms. Most people don’t even know the stroke has occurred. But it does involve a ruptured blood vessel. The damage can appear on an MRI or a CT scan. Importantly, those silent strokes can eat away at your memory.

It is common for several of these stealth strokes to take place over time. Researchers estimate that for every person who has a stroke with the usual signs of difficulty in movement or speech, there are 14 others who experience a silent stroke. A blood vessel has burst, cells have died. But the cells aren’t in a section of the brain that affects speaking or walking. The people don’t even know they have had anything happen.

Karen Furie, associate professor at Harvard Medical School and director of the Massachusetts General Hospital Stroke Center, says that even though most people don’t know it happened, “that doesn’t mean it’s insignificant.”

Even though a woman may not notice the effects immediately, a silent stroke can cause “subtle signs such as cognitive impairment.” The flow of information “in her brain needed for memory,” is impaired and can occur frequently.

In the stroke study, researchers looked at 650 people without a history of dementia. They used MRI’s and tracked disruptions in blood flow. More than 170 were found to have areas of dead tissue in their brains.

Dr. Furie said it wasn’t advisable for everyone to run out and have an MRI to see if they have dead spots in their brain. But she did advise the following:

  • Control your blood pressure by getting it checked regularly and taking blood pressure medicine, if you need it.
  • Limit salt to less than 1 teaspoon per day and follow the DASH eating plan, which has been shown to lower blood pressure about as much as medication in some people. (To learn more about this diet, visit: www.dashdiet.org/)
  • Aim to keep your total cholesterol levels below 200 mg/dL, and your LDL cholesterol below 100 mg/dL. To help lower your cholesterol, lose weight if you're overweight, consume
    less than 200 milligrams of cholesterol daily, and increase the fiber in your diet (20 to 30 grams of fiber each day is ideal).
  • Quit smoking. Smoking more than doubles your risk of a stroke. Talk to your doctor about nicotine-replacement products such as patches and gums, and medicines to help you quit.
  • Watch your weight. Aim for a body mass index between 19 and 25 (calculate your BMI at www.nhlbisupport.com/bmi).
  • Eat at least 1.5 cups of fruit and 2.5 cups of vegetables a day and cut back on foods like red meat and sweets to keep your weight within a healthy range.
  • Play tennis, swim, ride a bike, or take a brisk walk for 30 minutes a day, at least five days a week. A 2011 study in the journal Neurology found that getting regular, moderate to intense exercise can cut your risk of a silent stroke by 40 percent.

 

Tait Trussell is an old guy and fourth-generation professional journalist who writes extensively about aging issues among a myriad of diverse topics.

Meet Tait