"Whispering" Stroke Can Cause Harm

A surprisingly high number of Americans may suffer "whispering" strokes - attacks whose symptoms are so mild that they often go ignored, says a study in the medical journal Stroke.

About 18 percent of the almost 22,000 older adults in the new study reported having such symptoms, ones that can cause physical and mental harm.

People who experienced these symptoms had lower-than-normal scores on tests of physical and mental functioning.

"What we are trying to say to the lay public and primary care physicians is that these strokes are a major public health problem," says lead researcher George Howard, Dr. P.H., at the University of Alabama at Birmingham (UAB).

Symptoms Warrant a Doctor's Visit

Dr. Howard and his colleagues are publishing a series of reports on the study participants, all of whom were 45 years of age or older. About 40 percent of the participants are African American and half are women.

The participants filled out standard questionnaires on their mental and physical status and a separate form asking if they had experienced symptoms of a stroke, such as:

• sudden numbness or weakness of the face arm or leg, especially on one side of the body.
• sudden confusion, trouble speaking or understanding.
• sudden trouble seeing in one of both eyes.
• sudden severe headache with no known cause.
• sudden trouble walking, dizziness, or loss of balance or coordination.

In all, more than 3,400 participants said they had experienced such symptoms but had not been diagnosed with a either a stroke or a transient ischemic attack (also called a TIA or "mini-stroke").

"They didn't think the symptoms important enough to go to a doctor, or the doctor didn't think them important enough to warrant treatment," Dr. Howard says.

But damage had been done to these people, the researchers say. Their questionnaires showed a 5.5-point lower score on physical functioning and a 2.7-point lower score on mental functioning compared to people with no such symptoms.

"Now we are trying to see if there is an increased risk of stroke in this group," notes Dr. Howard.

Such an increase would indicate the need for treatment, such as prescribing aspirin to prevent stroke-causing blood clots, he explains.

Taking Note, Realizing Stroke's Results

The concept described by Howard's group is not new in medicine, says Dr. E. Steve Roach at Ohio State University and a spokesman for the American Heart Association.

"Lots of people have strokes that are not accompanied by symptoms," says Dr. Roach. "This is something that was noted as long as a century ago, when a clear-cut stroke would be found on autopsy in someone who had not reported one."

But the high incidence of what has been called "silent stroke" and what the Howard group is calling "whispering stroke" carries a clear message, he says.

"Clearly, the reason they are emphasizing this finding is to get the word out that if people have symptoms like these, they just shouldn't ignore it," says Dr. Roach.

"The first big message here is for individual people to seek treatment,” he notes. “The second message is for all of us as physicians to pay attention and not dismiss it when people come in to report these symptoms."

Always consult your physician for more information.