Stroke is one of the leading causes of death and disability worldwide. According to the World Health Organization's (WHO) Eastern Mediterranean Region, 1.5 crore people worldwide suffer a stroke annually.
A stroke occurs when blood flow to part of the brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients, which can then cause brain cells to die. While some people develop noticeable symptoms that prompt them to act quickly, others do not experience any pain or discomfort, leading to delayed treatment.
In an interaction with the OnlyMyHealth team, Dr Kailas Mirche, Senior Neurologist, CARE Hospitals, Hitech-City, Hyderabad, explains whether people can suffer from a stroke without any signs and shares silent symptoms.
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Can Stroke Occur Without Any Pain?
“Absolutely,” says Dr Mirche. “Many people assume a stroke must be accompanied by intense pain, but the brain tissue itself does not have pain receptors the way skin or muscles do.”
“In an ischaemic stroke, where a blood clot blocks blood flow, there is often no pain at all.
“Haemorrhagic strokes, which involve bleeding in the brain, may cause a sudden severe headache, but even those can sometimes be surprisingly painless. That’s why we emphasise watching for neurological symptoms rather than waiting for pain,” explains Dr Mirche.
A 2006 study published in JAMA Internal Medicine looked at more than 18,000 adults across the United States who had never been diagnosed with a stroke or a Transient Ischaemic Attack (TIA). Surprisingly, nearly 1 in 5 people reported at least one painless symptom suggestive of a stroke, such as sudden weakness or numbness on one side of the body, loss of vision, or trouble speaking or understanding speech.
The researchers also noted that many people experienced small, silent strokes without knowing it, highlighting the importance of early screening and preventive care to lower future stroke risk.
Silent Warning Signs Of Stroke
According to Dr Mirche, the warning signs of stroke can be subtle and easy to overlook. These include:
- Sudden weakness or numbness on one side of the face, arm, or leg
- Abrupt changes in speech, such as slurring or difficulty finding words
- Loss of vision in one or both eyes
- Loss of balance or coordination
- Sudden, unexplained confusion
Sometimes, these symptoms last only a few minutes, which we call a TIA or 'mini-stroke', but that is a serious warning that a major stroke may follow.
How Quickly Should You Act?
"Time is absolutely critical," emphasises Dr Mirche.
He says, "We often say 'time is brain' because millions of brain cells can be lost each minute blood flow is blocked. If you notice any of these signs, call emergency services right away, ideally within the first hour."
"Modern treatments, including clot-dissolving medication and mechanical clot removal, are most effective when started as soon as possible, often within a narrow window of a few hours."
Also Read: How To Recognise A Thunderclap Headache: Can It Be A Sign Of Stroke?
Role Of Regular Check-Ups
When it comes to strokes, especially silent ones, regular medical checkups are extremely important. It allows us to identify and manage the key risk factors long before a stroke occurs. According to Dr Mirche, monitoring blood pressure, blood sugar, and cholesterol levels; screening for heart rhythm problems; and reviewing lifestyle habits all make a tremendous difference.
“When we detect issues early, we can recommend medication, dietary changes, exercise plans, and sometimes simple procedures that dramatically reduce the likelihood of a sudden, and possibly painless, stroke,” he adds.
Conclusion
It is important to note that age is certainly a major factor for stroke, as the risk roughly doubles with each decade after 55. However, younger adults are by no means immune.
Dr Mirche shares, "I see strokes in people in their 30s and 40s, especially if they have high blood pressure, diabetes, high cholesterol, heart rhythm disorders like atrial fibrillation, or a family history of early stroke.
He concludes by emphasising healthy lifestyle habits and discourages smoking, heavy alcohol use, poor diet, and lack of physical activity.