In the

midst of a normal day, perhaps at work, on your usual

drive home or just sitting down to dinner, you have a

sudden, intense headache.

In one

terrifying moment, the world around you spins, you find

it difficult or impossible to speak, and you can't move

the right side of your body. Unable to prevent yourself

from falling, you may even lose consciousness. What

happens next?

Recognizing

the classic signs of a stroke, you or someone near you

gets you to the nearest hospital as quickly as possible.

It's imperative that you take advantage of the

"golden hour" - actually the first three hours

- after the event when clot bursting drugs can make the

difference between a frightening but temporary accident

and permanent disability.

But what if

you never experience the above symptoms, but you're over

50 and you've developed depression, difficulty with

memory and concentration and a slight lack of

coordination? You may not call 911 or race to the nearest

emergency room, but you should definitely see your doctor

to assess whether you've had one or more small,

"silent" strokes.

Silent

strokes, also called mini-strokes, may not even be

noticed. They happen when small blood vessels and tiny

capillaries of the brain become blocked by

atherosclerosis or rupture and bleed into surrounding

tissues. While the damage of a silent stroke may be

small, if enough of them occur over time, they can be

just as disabling as a major stroke, even leading to a

degenerative Alzheimer's-like condition called vascular

dementia.

According

to researchers at Duke University the first sign that

mini-strokes are occurring in a person over 50 may be the

onset of depression. A study led by David C. Steffens,

M.D., examined more than 3,600 elderly people and used an

MRI (magnetic resonance imaging) procedure of their

brains to test for small lesions (caused by silent

strokes) in the basal ganglia, an important region deep

within the brain. One function of the basal ganglia is to

produce the neurotransmitter serotonin, which is depleted

in the brains of depressed individuals.

The results

of the MRI studies were then correlated with the

subjects' scores on a test measuring depression. The

small lesions were found to increase the risk of

depression by 40 percent.

Steffens

cautioned that family physicians and even elderly

patients themselves may overlook the signs of depression

because they differ subtly from those of a younger

person. He noted that depression in the elderly is often

marked not by sadness, but by a sense of apathy and a

loss of interest in activities that used to engage them.

It's hard

to say how many victims have suffered from silent

strokes, because people are usually unaware of them and

don't seek treatment. Anyone found to have had a silent

stroke, however, is at risk of having a major stroke,

since the mechanisms for any size stroke are the same.

People over

50 who experiences dizzy spells, notices an unexplained

lack of coordination or suspects the onset of depression

should talk to their family doctors about the possibility

of silent strokes, and ask about medications or

life-style changes that can minimize their risks.

For

information about heart disease and stroke, phone

1-800-437-2423.