'Silent' Strokes Common in Older People
MRI Reveals Unrecognized Strokes, Aneurysms, and Brain Tumors
WebMD News Archive
Oct. 31, 2007 -- "Silent" strokes and other unrecognized brain
abnormalities -- including benign brain tumors and aneurysms -- are common
among older people, new research shows.
Brain imaging was performed on 2,000 people participating in an ongoing
study from the Netherlands designed to explore the effect of aging on the
brain. The average age of the study participants was 63.
Magnetic resonance imaging (MRI) revealed that 7% of the participants showed
evidence of a previous unrecognized, asymptomatic stroke.
An additional 1.6% had benign brain tumors and nearly 2% had aneurysms.
Only two of the people with incidental brain findings reported symptoms that
would indicate a neurological problem.
The findings are reported in the Nov. 1 issue of TheNew England
Journal of Medicine.
Silent Stroke, Major Stroke
The clinical relevance of these incidental brain findings is not completely
clear, but earlier studies by the same research team showed that the presence
of silent strokes on brain imaging more than doubled the risk for a subsequent
major stroke and dementia.
"We know that there is a relationship between asymptomatic stroke and
symptomatic stroke and dementia," researcher Aad van der Lugt, MD, tells
WebMD. "We now need strategies to prevent these consequences."
Stroke specialist Claudette Brooks, MD, of West Virginia University School
of Medicine, tells WebMD that many so-called "silent" strokes are not
silent at all.
"Many people ignore symptoms of a small stroke, or they may not
associate them with a stroke," she says.
Brooks says any symptoms that might indicate a stroke should always be
reported to a doctor, even if the symptom goes away.
According to the American Stroke Association, signs of a potential stroke
- Sudden numbness or weakness of the face, arms, or legs, especially on one
side of the body.
- Sudden confusion, trouble speaking, or trouble understanding.
- Sudden trouble seeing in one or both eyes.
- Sudden trouble walking, dizziness, and loss of balance or
- Sudden, severe headache with no known cause.
More MRI, More Discovery of Brain Problems
The fact that almost 2% of the study population had asymptomatic aneurysms
or benign brain tumors was more surprising to van der Lugt than the silent
He adds that as the use of brain imaging for diagnosis and clinical research
increases, more and more clinically ambiguous brain abnormalities will be
The best course of managing these asymptomatic brain issues is not known,
because it is not clear how often they lead to serious problems.
"We need studies to clarify the clinical implications of asymptomatic
brain abnormalities," van der Lugt says. "And people who participate in
[imaging] studies need to be made aware of the possibility of these incidental
findings which may not need treatment, but could lead to a lot of