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'Whispering Stroke' Can Cause Lasting Damage

Attacks with mild symptoms are too often ignored, experts say

THURSDAY, Aug. 2, 2007 (HealthDay News) -- A surprisingly high number of Americans may suffer "whispering" strokes -- attacks whose symptoms are so mild that they often go ignored but can nevertheless cause physical and mental harm, a new study finds.

About 18 percent of the almost 22,000 older adults in the study reported having such symptoms, according to a report in the Aug. 3 issue of Stroke. 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," said lead researcher George Howard, a professor of biostatistics at the University of Alabama at Birmingham School of Public Health.

Howard and his colleagues are publishing a series of reports on the study participants, all of who were 45 years of age or older. About 40 percent of the participants are black 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 ("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," Howard said.

But damage had been done to these people, the researchers said. 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," Howard said.

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

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

"Lots of people have strokes that are not accompanied by symptoms," Roach said. "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 said.

"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," Roach said. "The first big message here is for individual people to seek treatment. 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."

More information

The warning signs of stroke and what to do about them are described by the American Heart Association.

SOURCES: George Howard, Dr.P.H., professor, biostatistics, University of Alabama at Birmingham; E. Steve Roach, M.D., professor, neurology and pediatrics, Ohio State University, Columbus; Aug. 3, 2007, Stroke
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