A cerebral infarction (ischemic stroke) is a time-critical medical emergency where a blood vessel in the brain becomes blocked, cutting off blood flow and causing brain tissue to die. It accounts for approximately 70−80% of all strokes and can leave severe long-term disabilities such as paralysis and speech difficulties.
This guide explains the basics of cerebral infarction, the emergency signs (FAST) everyone must know, and the latest treatment methods. Time is crucial: If treated within 4.5 hours of onset, clot-busting t-PA therapy may be administered, which significantly impacts recovery.
1. What is a Cerebral Infarction (Ischemic Stroke)?
A cerebral infarction is a disease where blood flow to the brain is cut off due to a blockage in a cerebral blood vessel, leading to the death (necrosis) of brain tissue due to lack of oxygen.
It accounts for about 70−80% of all strokes, and approximately 100,000 people are affected in Japan annually.
2. Causes and Types
| Type | Characteristics | Cause |
| Lacunar Infarction | Blockage of small, deep blood vessels. | High blood pressure, diabetes, smoking. |
| Atherothrombotic Infarction | Blockage of large blood vessels due to atherosclerosis. | Atherosclerosis (High cholesterol, smoking, aging). |
| Cardioembolic Infarction | A blood clot travels from the heart to the brain. | Atrial fibrillation, arrhythmias (irregular heart rhythm). |
3. Main Symptoms (Remember FAST)
The FAST acronym is universally used to remember the warning signs of a stroke:
- Face: One side of the mouth droops, or the smile is uneven.
- Arm: One arm cannot be lifted, or feels weak.
- Speech: Slurred speech (dysarthria), or inability to speak (aphasia).
- Time: Time to call an ambulance immediately!
Other symptoms: Sudden severe headache, dizziness, vision loss, numbness, and difficulty walking.
4. Treatment
It is said that for every minute treatment is delayed, 1.9 million brain cells are lost. Time is brain.
| Timing | Treatment Method |
| Within 4.5 Hours of Onset | t-PA (Thrombolytic Drug): A clot-busting drug used to dissolve the blood clot. |
| Within 24 Hours of Onset | Thrombectomy (Clot Retrieval): Using a catheter to mechanically remove the clot from the vessel. |
| Beyond These Windows | Antiplatelet drugs (e.g., aspirin), rehabilitation. |
5. Prevention Methods
- Blood Pressure Management (Aim for <140/90 mmHg).
- Quit Smoking (Cessation).
- Regular Exercise (Target ≥30 minutes of walking per day).
- Treatment of Diabetes and Dyslipidemia (High Cholesterol).
- Check for Atrial Fibrillation (If an arrhythmia is present, use anticoagulants).
6. Potential Long-Term Sequelae
- Hemiplegia (Paralysis of one side of the body/limbs).
- Language impairment (Aphasia).
- Dysphagia (Difficulty swallowing).
- Cognitive decline.
