Could You Have a Stroke Without Even Knowing It?

Can you have a stroke without even realizing it?

Some strokes happen with no warning signs and no pain. These silent strokes can still harm your brain and affect your memory, balance, and thinking.

In September 2020, Lisa Feitelberg-Costa woke up and noticed something was wrong. Her left side felt weak, and she couldn't stand straight. Doctors quickly found that Lisa had an ischemic stroke caused by a 99% blockage in her carotid artery—the main blood vessel that carries blood to the brain. Without surgery, she faced the risk of more strokes, serious disability, or even death.

Lisa was shocked. She was 59, fit, and lived a healthy lifestyle. She exercised, ate well, and never missed a doctor’s appointment. Still, scans revealed she had been having small, unnoticed strokes for some time. This marked the beginning of a long recovery journey.

Dr. Richard Pin, a vascular surgeon, performed the surgery. Recovery wasn’t easy and Lisa explained that healing from a stroke affects the whole person—mind, body, and spirit. Some days brought progress; others brought setbacks. After rehab, Lisa continued therapy at home with a team of physical, occupational, and speech therapists. She later transitioned to outpatient care.

As Lisa healed, she realized she wanted to help others. She felt lonely and unsure during her recovery and wanted to connect with other survivors. She started a support group in September 2024. The group now has more than 100 members and meets monthly in Westport. It welcomes anyone dealing with major health changes—not just stroke survivors.

Lisa’s recovery is still ongoing, but she feels thankful. She can drive again, participate in daily life, and support others through their own healing.

Why They’re Hard to Spot

Many people don’t realize it, but you can have a stroke without even knowing it. These are called silent strokes, and they affect an estimated 8 to 10 million Americans every year. Unlike the more obvious strokes that cause sudden weakness, slurred speech, or facial drooping, silent strokes come with no clear symptoms. That’s what makes them dangerous. They happen quietly, often in areas of the brain that don’t control major body functions like movement or speech.

Doctors say that the signs of a silent stroke are easy to miss. They might look like normal aging—like mood swings, forgetfulness, or slight changes in balance. But these can actually be warning signs that blood flow to a part of the brain was lost, causing damage. A neurologist, Dr. Rajiv Padmanabhan, explains that silent strokes still harm the brain. In fact, once someone has had one, they are at higher risk for more strokes, including ones with serious, lasting effects.

Over time, repeated silent strokes can lead to major problems, like memory fading, thinking becomes harder, and people might struggle with planning, judgment, or making decisions. This kind of damage can lead to something called vascular dementia, which changes the way the brain works in everyday life. Brain scans like MRIs or CT scans are often the only way to know if someone has had a silent stroke.

While these strokes don’t always show signs right away, they’re not harmless. The American Stroke Association estimates that about one in four people over age 80 has had at least one silent stroke. These strokes might be silent, but they leave a mark.

The good news? There are ways to lower your risk. High blood pressure is one of the biggest red flags. If you have it, it’s important to take your medication and follow your doctor’s advice. Other major risks include atrial fibrillation (an irregular heartbeat), sleep apnea, high cholesterol, and atherosclerosis—when plaque builds up in the arteries and can block blood flow. If you’re living with any of these, treatment and lifestyle changes are key.

Simple actions can make a big difference, like quitting smoking, staying active, and eating a Mediterranean-style diet rich in fruits, vegetables, and fiber, all help protect the brain. Managing stress is also important, since stress can raise blood pressure and cause other health problems that lead to stroke.

Doctors also warn about mini-strokes, or TIAs (transient ischemic attacks). These are like temporary strokes—symptoms may go away in minutes, but they are a major red flag. They signal a high risk of a bigger stroke in the near future.

Time is critical—treatment works best if it starts quickly. Even if there’s no pain, don’t ignore strange symptoms. Stroke isn’t always dramatic. Sometimes, it’s silent. But the damage is real, and the risks are too.

End Note

Strokes don’t always shout—they often whisper. They can strike quietly, without warning, and still leave lasting damage. But knowledge is power. When you understand the risks, notice the subtle signs, and take steps to protect your health, you give yourself the best chance.

Keep your blood pressure in check, follow your doctor’s advice, and don’t brush off small changes in how you think or feel. Your brain matters. Take care of it, starting now.