Stroke is the leading cause of the need for long-term care in Japan, affecting over 100,000 people annually. It is divided into two major types: Cerebral Infarction (ischemic stroke, 70–80%), where a blood vessel in the brain is blocked, and Intracerebral Hemorrhage or Subarachnoid Hemorrhage (20–30%), where a blood vessel ruptures. The response immediately after onset for either type significantly influences the rest of the patient’s life.
Types of Stroke
| Type | Proportion | Mechanism | Characteristics |
| Cerebral Infarction(Ischemic Stroke) | Approx. 70–80% | A blood vessel in the brain becomes blocked. | Symptoms often develop gradually. |
| Intracerebral Hemorrhage | Approx. 15–20% | A blood vessel in the brain ruptures and bleeds into the brain tissue. | Symptoms often become severe rapidly. |
| Subarachnoid Hemorrhage (SAH) | Approx. 5–10% | An aneurysm on the brain’s surface ruptures. | Characterized by a sudden, extremely severe headache (“like being hit by a hammer”). |
Main Causes and Risk Factors
- High Blood Pressure (Hypertension is the most critical factor!)
- Diabetes
- Dyslipidemia (High Cholesterol)
- Smoking
- Excessive Alcohol Consumption
- Atrial Fibrillation (A type of arrhythmia)
- Obesity and Lack of Exercise
- Advanced Age (Sharp increase after age 65)
Main Symptoms that Appear Suddenly (Remember the acronym FAST!)
| Acronym | Meaning (English) | Japanese | How to Check |
| F | Face Drooping | 顔がゆがむ (Face Distortion) | Ask the person to smile; check if one corner of the mouth doesn’t rise. |
| A | Arm Weakness | 腕が上がらない (Arm Cannot Be Raised) | Ask the person to hold both arms out in front; check if one arm drifts downward. |
| S | Speech Difficulty | 言葉がもつれる・出ない (Slurred or Absent Speech) | Ask the person to repeat a simple phrase like, “It’s a nice day today.” |
| T | Time to Call 119 | すぐに119番！ (Call 119 Immediately!) | If any of the above occur, call an ambulance as quickly as possible! |
Other sudden symptoms highly indicative of a stroke:
- Severe headache
- Dizziness or unsteadiness
- Double vision
- Numbness or paralysis on one side
If Stroke Strikes, “Time is Brain!”
Especially for Cerebral Infarction, administering t-PA (a clot-busting drug) within 4.5 hours of onset can dramatically reduce residual deficits.
→ Therefore, never “wait and see”! Call 119 immediately!
What You Can Do Now for Prevention
- Make a habit of checking your blood pressure (Target is below 140/90 mmHg).
- Quit smoking.
- Limit salt intake to 6–7g/day (The Japanese average is over 10g).
- Exercise for ≥30 minutes daily.
- Eat a diet focused on vegetables and fish.
- If you have atrial fibrillation, take your anticoagulant medication as prescribed.
In short, stroke is the “summation of lifestyle diseases.”
