Silence of Apoplexy

"Silent" strokes may be prevalent among elderly, study indicates.

"'Silent' strokes and other unrecognized brain abnormalities -- including benign brain tumors and aneurysms -- are common among older people," according to findings published in the Nov. 1 issue of the New England Journal of Medicine.

Dutch researchers performed brain imaging "on 2,000 people participating in an ongoing study...designed to explore the effect of aging on the brain. The average age of the study participants was 63." MRI "revealed that seven percent of the participants showed evidence of a previous unrecognized, asymptomatic stroke."

In addition, "1.6 percent had benign brain tumors, and nearly two percent had aneurysms." The researchers were unable to determine "[t]he clinical relevance of these incidental brain findings." However, study author Aad van der Lugt, M.D., stated, "We know that there is a relationship between asymptomatic stroke and symptomatic stroke and dementia. ...

We now need strategies to prevent these consequences." One lesson from these findings, according to stroke specialist Claudette Brooks, M.D., of West Virginia University School of Medicine, is that patients should always inform their physicians of "any symptoms that might indicate a stroke,...even if the symptom goes away."

"The researchers had expected to find some people with undiagnosed infarcts, because blood vessel changes are common in older adults." According to Dr. van der Lugt, "we were very surprised to find such a high frequency of other findings such as aneurysm and meningiomas, as previous studies reported much lower frequencies."

The study's conclusions "may have implications for patients in the future: As more of these abnormalities are spotted with more sophisticated equipment during routine medical tests," some physicians "may urge patients to have surgery or other treatment as a precaution."

Alternatively, "some patients may push" their physicians to repair "the potential problem." According to the researchers, study "participants were mostly white, middle class and healthy; whether the same brain abnormalities would be found in other groups of people isn't known."