Could Mikiō Date’s Hospitalization Have Been Prevented!? Specialist Warns of “Signs That Disappear Temporarily” and “Summer Strokes and Silent Strokes”

“I just can’t seem to talk…”

Mikiō Date (52) of the comedy duo “SANDWICHMAN” reportedly told his partner, Takeshi Tomizawa (52), this at the meeting spot before work. At the urging of those around him, he immediately went to the hospital, where he was diagnosed with a “cerebral infarction.” He will be taking a break from work for the time being.

Fortunately, thanks to prompt medical care, the situation didn’t become serious, but Date had previously mentioned feeling unusual symptoms, such as “sometimes I can’t focus my eyes.”

With cerebral infarction, “warning signs may appear and then disappear.”

Before a full-blown stroke occurs, symptoms such as paralysis or numbness in the limbs, difficulty speaking, or blurred vision may temporarily appear and then disappear as if nothing had happened. The number of stroke patients begins to rise in one’s 50s.The stroke that struck Date, who was 51 at the time of his onset, is by no means a disease that only affects the elderly—it can strike people in their prime as well.

To what extent should we be wary of “abnormalities that have resolved themselves”? And what are the signs we need to know to ensure we don’t miss a stroke?
We spoke with Dr. Satoshi Ozaki, Chairman of the Board at NALU Medical Corporation and the Ebina Neurological Clinic (quotes below are from Dr. Ozaki).

The “Countdown” That Begins in Your 50s

A stroke is a condition in which a blood vessel in the brain becomes blocked, cutting off the blood supply.

“When blood flow is cut off, oxygen and nutrients can no longer reach the brain, causing damage to brain cells. Depending on which blood vessel is blocked, various symptoms may appear, such as paralysis of the limbs, speech disorders, and visual impairments.

Although cerebral infarction is often perceived as a ‘disease of the elderly,’ the number of patients begins to rise starting in one’s 50s. In one’s 50s, conditions such as high blood pressure, dyslipidemia, and diabetes become more common. This is the age when damage to blood vessels caused by years of lifestyle habits begins to manifest.”

Cerebral infarctions are broadly classified into three types based on their causes.

“The first is ‘atherothrombotic stroke.’ This type occurs when blood vessels narrow due to atherosclerosis, leading to blockages caused by blood clots or other factors. It is closely associated with conditions such as high blood pressure, diabetes, dyslipidemia, and smoking.

The second is ‘cardioembolic stroke.’ This occurs when a blood clot formed in the heart travels to the brain and blocks a blood vessel. A typical cause is a heart rhythm disorder called ‘atrial fibrillation,’ which can lead to sudden onset of severe symptoms.

The third type is “lacunar infarction.” This occurs when small blood vessels deep within the brain become blocked and is closely associated with high blood pressure. Although the affected area is small and symptoms may be relatively mild, these episodes can recur.”

Although cerebral infarction is a disease that strikes suddenly, it is not uncommon for it to be preceded by years of progressive atherosclerosis and lifestyle-related diseases.

TIA: A Condition You Must Not Overlook

A “transient ischemic attack (TIA)” may occur before a full-blown stroke.

“Blood flow to the brain is temporarily impaired, causing neurological symptoms similar to those of a stroke. However, since the symptoms disappear afterward, many people mistakenly believe they have ‘recovered.’”

Be on the lookout for the following symptoms:

・Sudden weakness or numbness in one side of the body
・Facial drooping on one side
・Slurred speech or difficulty speaking
・Inability to understand what others are saying
・Sudden blurred vision in one eye

“The key point is that these symptoms occur suddenly. A TIA is a warning sign indicating a risk of a stroke. Even if the symptoms disappear, please seek medical attention immediately.”

Sudden difficulty speaking is also one of the classic symptoms that should raise suspicion of a stroke. That’s why it’s important to remember “FAST.”

F = Face: When you smile, does one side of your mouth droop?

A = Arm: When you extend both arms forward, does one arm fail to stay raised?

S = Speech: Are there any abnormalities, such as slurred speech or an inability to speak?

T = Time: If any of the above apply, note the time the symptoms began and call 911 immediately.

“With a stroke, knowing ‘when the symptoms began’ is extremely important. The person may have trouble speaking or may not even realize something is wrong. It’s also important for family members or coworkers to notice that something is ‘different from usual.’”

Summer Strokes: “Danger Even While You Sleep”

During this time of persistent, sweltering late-summer heat, dehydration is a major concern.

“During hot weather, you lose fluids through sweating. If you don’t replenish them adequately and become dehydrated, your circulating blood volume decreases, and your blood becomes thicker. People who are already at risk for conditions such as atherosclerosis or lifestyle-related diseases need to be especially careful.”

You lose fluids not only under the blazing sun but also while you sleep.

“Alcohol has a diuretic effect. Be careful not to drink large amounts of alcohol on hot nights and then fall asleep right away.”

It’s important to stay hydrated by drinking fluids frequently. However, people who have been given specific instructions regarding fluid intake due to heart or kidney disease must follow their doctor’s advice.

Also, during hot weather, people may mistakenly attribute fatigue or dizziness to “summer fatigue” or “heatstroke.” If symptoms such as paralysis on one side of the body, facial asymmetry, or speech difficulties appear suddenly, a stroke should be suspected.

There are cases where a person experiences a cerebral infarction without being aware of it at all. This is known as a “silent stroke.” Medically, it is referred to as an “asymptomatic cerebral infarction.”

“Even if the person has no subjective symptoms, traces of a small cerebral infarction that occurred in the past may be discovered by chance during an MRI scan performed for another reason. Asymptomatic cerebral infarction is an important finding when considering the risk of future stroke.”

According to international studies cited in the guidelines of the Japan Stroke Society, people with asymptomatic cerebral infarction were approximately twice as likely to develop a stroke later on compared to those without it. Furthermore, another study reported that people with asymptomatic cerebral infarction had a 3.9-fold higher risk of subsequent stroke.

“High blood pressure, in particular, is a major risk factor. If an asymptomatic cerebral infarction is detected, it is important to assess and properly manage your risk factors, such as high blood pressure, diabetes, and dyslipidemia.”

When a cerebral infarction is suspected, hospitals use CT or MRI scans to assess the condition of the brain. The key to treatment is to restore blood flow to the blocked blood vessel as quickly as possible.

“One of the standard treatments is ‘intravenous t-PA therapy,’ which dissolves blood clots. Provided the patient meets the criteria, treatment is generally initiated within 4.5 hours of symptom onset. In cases where a large cerebral blood vessel is blocked by a clot, ‘mechanical thrombectomy’—which uses a catheter to remove the clot—may be performed.”

Thrombectomy may be indicated even in cases where some time has passed since the onset of symptoms, provided certain conditions—such as the patient’s condition and imaging findings—are met.

“A stroke is a race against time. The sooner treatment begins, the greater the chance of saving more brain tissue. It is crucial to take action as soon as you notice any abnormalities. For prevention, start by monitoring your blood pressure, blood sugar levels, and LDL cholesterol.

Some people ignore abnormalities pointed out during health checkups simply because they have no symptoms, but it’s important to address these issues by improving lifestyle habits and seeking necessary treatment. Arrhythmias, such as atrial fibrillation, can also lead to ischemic stroke. If an arrhythmia is detected during a checkup, please do not ignore it.”

A stroke can strike suddenly, out of the blue.

However, the underlying causes—such as high blood pressure and atherosclerosis—can develop over many years. Furthermore, warning signs before the onset of a stroke may even disappear temporarily. The stroke that struck 51-year-old Date is by no means someone else’s problem, even for those in their prime who think, “I’m still in my 50s, so I’ll be fine.”

Facial asymmetry, paralysis or weakness in one arm, speech difficulties—

The key is not to overlook those fleeting signs and to seek medical care as quickly as possible. That is the turning point that can save a life and protect one’s future from the effects of a stroke.