Defend the brain: How to prevent and respond to a stroke

Editor's note: World Stroke Day is observed annually on October 29 to highlight a critical fact: every minute counts when responding to a stroke. In this article, Fang Jie, an associate chief physician at The First Affiliated Hospital of Xiamen University, explains the connection between stroke and headache, outlines the key warning signs and highlights the vital "FAST" response protocol.

One morning in July 2025, Zhang was jolted awake by a tearing pain in his head. The 55-year-old high school math teacher had never experienced such pain before.

"It felt as if someone was setting off firecrackers in my head," he recalled after treatment.

He struggled to sit up and get a drink, only to discover that the right side of his body had gone numb.

"In that moment, I thought it might be from sleeping in an awkward position that caused the numbness," he said.

Fortunately, Zhang's wife, a retired nurse, recognized the early warning signs of a stroke when she saw her husband's slurred speech and paralysis on one side of his body, and immediately called the ambulance.

Upon arrival at the hospital, he was diagnosed with a hemorrhagic stroke, a condition caused by bleeding in or around the brain. With timely treatment, his condition was stabilized. If he had arrived at the hospital any later, he might have been bedridden for life or even died.

Zhang now persists in his daily rehabilitation exercises. Despite limited dexterity in his right hand, he is able to walk independently.

Headache is prevalent among stroke patients in China. Public data shows that a headache can serve as a precursor to a stroke, occurring in about 20 percent of patients before the stroke attack. It can also be a significant clinical manifestation during a stroke, present in about 27 percent of patients with ischemic stroke, a condition caused by a clot, at onset. Moreover, headache may persist as a post-stroke symptom, affecting between 1 percent and 23 percent of patients for more than three months.

Additionally, migraine is an independent risk factor for stroke, separate from vascular factors, and may increase the risk of stroke twofold.

Types of stroke

A stroke is a serious medical condition that occurs when the blood supply to a part of the brain is interrupted or severely reduced. It deprives brain tissue of oxygen and nutrients. It is a disease characterized by high rates of recurrence, disability and mortality, which not only leads to a profoundly diminished quality of life for the patient, but also imposes a heavy caregiving and economic burden on families and society.

It is the second leading cause of death globally and the primary cause of mortality and disability among adults in China.

There are two major types of stroke: ischemic stroke and hemorrhagic stroke.

Imagine that a major highway at rush hour is suddenly blocked by giant boulders. This depicts the core issue of an ischemic stroke. When blood vessels are blocked by clots, brain cells, similar to fish out of water, are starved of oxygen. In this emergency, a staggering 1.9 million nerve cells die every minute.

Hemorrhagic stroke is analogous to a burst water pipe. In patients with hypertension, blood vessel walls endure immense pressure over time until they finally rupture under the strain. Torrents of blood surge into the brain, compressing delicate nerve tissue.

Responding to a stroke

Stroke, as an acute cerebrovascular disease, yields more favorable recovery outcomes with earlier treatment. For ischemic stroke, the most common type of stroke, there is a critical "golden hour" for treatment. Doctors have about 4.5 hours from the first symptoms to use powerful "clot-busting" drugs or a procedure to remove the clot. Acting within this window can dramatically reduce the chances of permanent disability or death.

So how can we detect stroke early? Here are some recommendations per the classic "FAST" guideline.

"F" represents face

Does the patient have a drooping mouth or face? Can the patient make a symmetrical smile?

"A" represents arms

Does the patient experience weakness in one side of the body? Can the patient lift both arms?

"S" represents speech

Does the patient produce slurred speech or difficulty speaking fluently?

"T" represents time

If any of these symptoms are found, a stroke is strongly suspected. If this happens, do not hesitate. Avoid self-administering medication or water, and seek help immediately—symptoms will not subside on their own. Emergency services need to be provided immediately to facilitate urgent transfer to the nearest stroke center.

Populations at risk

Certain groups of people are more likely to have a stroke. Topping the list are those with high blood pressure, high cholesterol and high blood sugar because they all silently damage your blood vessels in ways that directly lead to strokes.

People with a heart condition called atrial fibrillation are also at high risk for stroke. In this condition, the heart doesn't beat properly, which can cause blood clots to form inside the heart. If a clot breaks free, it can travel directly to the brain, get stuck in a blood vessel, and cause a stroke.

Meanwhile, unhealthy lifestyle habits, including smoking, excessive drinking, high-sodium and high-fat diets, lack of exercise and obesity, can also significantly increase the risk of stroke.

Genetic factors cannot be overlooked either. Individuals with a family history of stroke should remain particularly vigilant at all times.

Building your health defenses

Though stroke is a frightening disease, it is both preventable and treatable. Dietary control and regular physical activity are emphasized as primary measures for stroke prevention.

It is advised to maintain a diet low in salt, fat and sugar and increase consumption of vegetables, fruits and whole grains. It is also suggested to ensure at least 150 minutes of moderate-intensity exercise each week, such as brisk walking, jogging or swimming.

The cornerstone of stroke prevention lies in the strict control of high blood pressure, high blood sugar and high cholesterol through regular monitoring and strict adherence to prescribed medication.

Quitting smoking completely and limiting alcohol consumption strictly are strongly recommended to eliminate their ongoing damage to blood vessels.

It is also crucially important to learn how to manage emotions and weight, and maintain a positive mindset to avoid prolonged stress and extreme fatigue.

Finally, regular check-ups are necessary. Individuals over 40 and those with risk factors should undergo specialized screenings periodically to detect and address potential health issues early.

Text is translated by Yang Aixin. Cover image is designed by CGTN's Liu Shaozhen. 

(This medical advice is for informational purposes only. Please consult your doctor for personal medical guidance.)