Can You Have a Stroke and Not Know It?

Study Shows Some People Have Mild Strokes That Aren't Diagnosed

Medically Reviewed by Louise Chang, MD on October 09, 2006
From the WebMD Archives

Oct. 9, 2006 -- Many U.S. adults aged 45 and older may have had a stroke without realizing it, a new study shows.

People should learn stroke's warning signs and immediately seek emergency medical help if those symptoms appear, write the researchers.

Before you read about their study, which appears in the Archives of Internal Medicine, review stroke's possible warning signs:

  • Sudden weakness or numbness in the face, arm, or leg on one side of the body
  • Abrupt loss of vision, strength, coordination, sensation, speech, or the ability to understand speech. These symptoms may become more marked over time.
  • Sudden dimness of vision, especially in one eye
  • Sudden loss of balance, possibly accompanied by vomiting, nausea, fever, hiccups, or trouble with swallowing
  • Sudden and severe headache with no other cause followed rapidly by loss of consciousness -- indications of a stroke due to bleeding
  • Brief loss of consciousness
  • Unexplained dizzinessdizziness or sudden falls

If you or someone with you shows any possible signs of stroke, don't hesitate. Get emergency medical care right away.

Some stroke medicines must be given shortly after stroke symptoms start, and those drugs can make a big difference in the outcome of a stroke.

Stroke Symptoms Study

The new study on stroke symptoms comes from researchers including Virginia Howard, MSPH, of the University of Alabama at Birmingham.

By telephone, Howard's team interviewed more than 18,400 U.S. adults aged 45 and older (average age: nearly 66).

All of the participants said they had never been told that they had had a stroke or a "mini-stroke" (transient ischemic attack, or TIA). The group was evenly split between whites and blacks. Blacks are at higher risk of stroke than whites.

Half of the participants live in the so-called "stroke belt" states -- North Carolina, South Carolina, Georgia, Alabama, Mississippi, Tennessee, Arkansas, and Louisiana -- which have particularly high stroke rates.

Have You Had These Symptoms?

Participants answered six questions about stroke symptoms:

  • "Have you ever had sudden painless weakness on one side of your body?" Nearly 6% said yes.
  • "Have you ever had sudden numbness or a dead feeling on one side of your body?" More than 8% said yes.
  • "Have you ever had sudden painless loss of vision in one or both eyes?" More than 4% said yes.
  • "Have you ever suddenly lost one half of your vision?" About 3% said yes.
  • "Have you ever suddenly lost the ability to understand what people are saying?" Nearly 3% said yes.
  • "Have you ever suddenly lost the ability to express yourself verbally or in writing?" Almost 4% said yes.

Overall, nearly 18% of the group reported having had at least one of those symptoms.

Those participants were more likely to be black, to have lower incomes and education levels, and to rate their overall health as "poor" or "fair" instead of "excellent," "very good," or "good."

The study doesn't show whether those people actually had strokes or sought care for their stroke symptoms.

Stroke Risk

Participants got a brief checkup three or four weeks after being interviewed by the researchers.

Using information from those checkups, Howard's team calculated each person's odds of having a stroke in the next 10 years, based on factors including age, smoking status, blood pressure, heart diseaseheart disease, and diabetesdiabetes.

Participants with poor stroke-risk-factor scores were particularly likely to have reported experiencing stroke symptoms.

The findings raise the possibility that some participants may have had mild strokes that hadn't been diagnosed, the researchers note.

Show Sources

SOURCES: Howard, V. Archives of Internal Medicine, Oct. 9, 2006; vol 166: pp 1952-1958. WebMD Medical Reference: "Understanding Stroke -- Symptoms." News release, JAMA/Archives.

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