Focusing On Silent Strokes

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The American Heart Association/American Stroke Association are joining organizations around the globe for World Stroke Day 2008 on Oct. 29 to highlight the importance of recognizing, treating and preventing “silent strokes.”

The World Stroke Day 2008 theme is “little strokes, big trouble.”

Subclincial stroke, or “silent stroke,” is a brain injury likely caused by a blood clot interrupting blood flow in the brain. It’s “silent” because it has no symptoms. But doctors can detect brain damage with brain imaging tests. “Silent stroke” is a risk factor for future strokes and a sign of progressive brain damage that may result in long-term dementia.

The World Stroke Day 2008 proclamation says subclinical (silent) strokes can occur five times as often as strokes and can affect thinking, mood/depression and personality.

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An editorial in Stroke: Journal of the American Heart Association calls for “renewed vigor and commitment” to recognize “silent stroke.”

“By now it has become evident that ‘silent strokes’ are the most common type of strokes,” wrote Vladimir Hachinski, M.D., D.Sc., editor-in-chief of the journal. “From a practical point of view, it becomes apparent that some of the symptoms that elderly individuals manifest — such as changes in judgment, intellectual ability, personality change, and particularly depression — may be associated with subclinical strokes and white matter changes in the brain.”

Hachinski, professor of Neurology and Distinguished University Professor at the University of Western Ontario, Canada, suggested that a five-minute screening test for vascular cognitive impairment and Alzheimer’s disease be used to help identify “silent stroke” followed by brain imaging if “silent stroke” is suspected.

A recent study published in Stroke found that about 10 percent of the apparently healthy middle-aged participants with no symptoms of stroke were injured from “silent strokes.”

“We need to implement what we know and learn as we do it, so we can continue to improve treatment and prevent all types of stroke,” Hachinski said.

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