Yes. Small strokes can occur in areas that produce no obvious symptoms, and are often found incidentally on a scan done for something else. Minor strokes are also frequently dismissed at the time as tiredness, a trapped nerve or a funny turn.
Yes. Small strokes can occur in areas that produce no obvious symptoms, and are often found incidentally on a scan done for something else. Minor strokes are also frequently dismissed at the time as tiredness, a trapped nerve or a funny turn.
A silent cerebral infarction is an area of completed damage found on imaging in someone with no recollection of a corresponding event. They occur in regions where the damage does not produce a clear deficit, and they are usually discovered on a scan performed for headache, dizziness, head injury or memory assessment. They are more common with increasing age and with untreated blood pressure, diabetes, atrial fibrillation and smoking. Finding one is not trivial and not something to dismiss because there were no symptoms.
Two reasons, and both are actionable. First, a silent infarct indicates that the mechanism which caused it is present and untreated, and it raises the risk of a future symptomatic stroke. Second, accumulating silent damage contributes to vascular cognitive impairment, affecting processing speed, attention and planning, and to gait change and falls. So the finding is best read as information about the future rather than a record of the past, and it prompts the same search for a mechanism as a symptomatic stroke would.
This is probably commoner than genuinely silent stroke. Symptoms are reinterpreted at the time: arm heaviness blamed on sleeping awkwardly, brief speech difficulty on tiredness, sudden clumsiness on clumsiness, transient vision loss in one eye on a migraine. Posterior circulation strokes are particularly easy to miss, presenting with vertigo, unsteadiness or double vision rather than the FAST signs. Older adults living alone, and people with existing cognitive impairment, are most likely to have an event pass without assessment.
If a scan has reported an old infarct, it is worth a proper vascular assessment rather than reassurance: blood pressure, heart rhythm monitoring for atrial fibrillation which is often intermittent, glucose, cholesterol, and carotid imaging where relevant. Treatment then follows the mechanism. If you suspect an unrecognised event in the past, say so, because it changes how aggressively risk is managed. Carotid ultrasound, MRI and CT are arranged at an imaging centre; transcranial Doppler is performed here. Adults 18 and older.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: stroke; MedlinePlus: stroke (medical encyclopedia); National Institute of Neurological Disorders and Stroke.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.