"Whispering strokes" often go unheard, but still cause damage

A study finds that even minor strokes can lead to significant impairment, and it calls for greater awareness of symptoms.

By Victoria Stagg Elliott, AMNews staff. Aug. 27, 2007.

Stroke symptoms are common among people older than 45, but many of these patients never receive a diagnosis or related medical care. Their untreated array of symptoms -- termed "whispering strokes" in a study published in the Aug. 2 Stroke -- can lead to a lower quality of life and declines in physical functioning comparable to that from a confirmed transient ischemic attack. Cognitive problems also are worse in this population, according to the study.

"These results show a need for greater awareness of stroke symptoms and a need to take these symptoms seriously," said George Howard, DrPH, lead author and the chair of biostatistics at the University of Alabama at Birmingham's School of Public Health.

Researchers analyzed questionnaires about mental and physical status completed by 21,803 participants of the Reasons for Geographic and Racial Differences in Stroke project. Previous papers from this effort found that 7% of participants had a diagnosis of TIA or stroke, but 18% had symptoms without a diagnosis. The authors hope that this more recent publication will lead to increased emphasis on milder symptoms. They also hope that these patients will receive treatment to reduce their risk of having a more debilitating event.

"The best way to treat a stroke is to prevent it from ever happening," Dr. Howard said.

Experts praised this paper for bringing attention to what many suspect is the largely unrecognized area between the silent strokes, which are detected on imaging but have no or minimal symptoms, and the frank strokes, which can be so destructive.