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Treatment for Intracerebral Hemorrhage: Mastering the “6-Hour Barrier” and Emergency Surgical Indications by Location (Cerebellar, Putaminal)

The treatment for Intracerebral Hemorrhage (ICH) evolves rapidly depending on the time elapsed since onset and the location of the bleeding. The first 6 hours, in particular, constitute the "Hyperacute Phase," where treatments aimed at halting the expansion of the hemorrhage and controlling intracranial pressure have the greatest impact on prognosis.
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Symptoms of Intracerebral Hemorrhage: 5 Major Danger Signs to Save a Life – Symptom Changes and the Importance of the “6-Hour Window”

Intracerebral Hemorrhage (ICH) is an extremely dangerous condition where a patient's state can change drastically and become life-threatening within just a few hours of onset. The first 6 hours are particularly critical—the "battleground for treatment"—as bleeding is likely to expand, and the risk of loss of consciousness or respiratory arrest due to brainstem compression is highest.
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Types of Intracerebral Hemorrhage: A Comprehensive Guide to 5 Major Types—Causes, Symptoms, Severity, and Emergency Signs

Intracerebral hemorrhage (ICH) is a severe condition where a blood vessel within the brain ruptures, causing bleeding that destroys or compresses brain cells. The location of the bleeding significantly affects its cause, presenting symptoms, severity, and treatment plan. ICH is primarily classified into five types, ranging from Putaminal Hemorrhage, which is most frequent in Japan, to Pontine Hemorrhage, which has the highest fatality rate.
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Comparison of Cerebral Hemorrhage and Cerebral Infarction: The “Ultimate Comparison Table” for Life Preservation and the Golden Rules of Initial Response

Cerebral hemorrhage (intracerebral hemorrhage) and cerebral infarction (ischemic stroke), often collectively referred to as "stroke," have fundamentally different mechanisms of onset, fatality rates, treatments, and keys to prevention. While cerebral infarction is overwhelmingly more common, occurring 2 to 3 times more frequently annually and showing significant treatment advancements, the threat of cerebral hemorrhage remains significant, with a high fatality rate of 30–50%.
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【Cerebral Infarction Insurance Payout Guide】Conditions for Payouts: ¥200,000−¥1,000,000 from Medical Insurance, ¥1,000,000−¥5,000,000from Critical Illness Insurance

Acute treatment for cerebral infarction is expensive, and subsequent long-term rehabilitation and persistent sequelae often lead to increased living expenses. This frequently results in a financial burden that cannot be fully covered by public health insurance (High-Cost Medical Expense System).
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【Cost of Cerebral Infarction】Complete Guide to the June 2025 Revision of Medical Fees! What Changes with 25,000 Points for Thrombectomy and Expanded Early Rehab

Cerebral infarction treatment is a "race against time," and because it involves highly advanced medical technology, it incurs significant costs. The June 2025 revision of medical fees introduced critical changes to improve the quality and continuity of stroke care, including raising the points for thrombectomy and expanding the duration of early rehabilitation.
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【Cerebral Infarction Hospital Stay】The 90−120 Day Process: Acute/Recovery Phase Transfer and Rehabilitation Duration

One of the major concerns for patients and families following a cerebral infarction is the question of "how long the hospital stay will be." As of 2025, stroke treatment in Japan is typically divided into two phases: "Acute Hospital Treatment" and "Intensive Training at a Recovery Rehabilitation Ward." The most common scenario involves a total hospital stay of approximately 90−120 days.
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【Cerebral Infarction Sequelae】Complete Guide by Frequency: Paralysis, Aphasia, Dysphagia, and More! Maximizing Recovery in the “First 3 Months”

While acute treatment for stroke is vital for survival, the way a patient copes with the subsequent long-term effects (sequelae) significantly determines their Quality of Life (QOL). Sequelae extend beyond "hemiplegia" to include higher brain function disorders affecting language, memory, and emotion, each requiring appropriate rehabilitation.
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【Cerebral Infarction Prevention】Reduce Stroke Risk by 50%! Focus on Blood Pressure, Smoking Cessation, and AFib Treatment

Cerebral infarction (stroke) is the "No. 1 Preventable Disease"—with appropriate measures, you can reduce your risk of onset by half or more. Focusing on the three major risk factors for stroke in Japan—High Blood Pressure, Smoking, and Atrial Fibrillation (AFib)—will significantly influence your future health.
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【Cerebral Infarction Treatment】4.5 Hours from Onset: A Matter of Life and Death! Explanation of rt-PA and Thrombectomy

Cerebral infarction treatment demands extremely rapid decision-making and action, based on the principle that "Time equals Brain." The time elapsed since onset drastically changes which treatments can save a life and minimize long-term disabilities. Crucially, contemporary standard treatment focuses intensive, powerful therapies during the immediate hours following onset.