On the occasion of the World Stroke Day on October 29, Dr. Anna Rosell, principal investigator of the Neurovascular Disease group at Vall d'Hebron Research Institute (VHIR) speaks of the studies they are doing in this field.A stroke is a medical emergency that occurs suddenly when an artery of the brain is blocked or broken. The World Health Organization estimates that about 15 million people suffer a stroke each year, of which about 5 million die and another 5 million survive the acute phase of the disease with some kind of functional neurological sequelae. Despite the high incidence and severity of the disease, improved patient care in recent years in specialized stroke units and the introduction of new treatments in the acute phase of the illness has improved the prognosis of patients who are treated in our centres.Assistance of patients with stroke is done holistically from the most acute phase of the disease to the stages of rehabilitation, but also through programs for primary and secondary prevention in control of their risk factors. Similarly, at the Neurovascular Disease Research Laboratory of VHIR we dedicate our efforts on translational research in the different phases of the disease. In terms of Stroke Prevention, we have started the ISSYS project to identify people who are at increased risk of stroke for the first time from the information provided by brain imaging techniques and with the help of clinical history and determining biomarkers. Thus we have identified that up to 10% of hypertensive patients have brain infarcts, despite not having presented any symptoms, and we have described the consequences that this asymptomatic damage has on cognitive function. At the present time we investigate how these silent heart attacks (and other lesions) accumulate over time as we age.Research on Neuroprotection and Biomarkers aims to identify and implement the use of molecular biomarkers in various clinical stages of the pathology of the stroke, and as new therapeutic targets in the acute phase of the disease. We work with various molecular techniques in the field of omics, both with samples from patients and experimental models, participating in several European projects such as the EuroHYP-1, the RESSTORE, or PROOF that combine the implementation of multicentre clinical trials with research on biomarkers. Nationally we coordinate multicentre projects (StrokeChip and AFRICAT) in which we investigate the use of new technologies to improve diagnosis and treatment. The results in recent years have enabled us to transfer the results in the form of patents and collaborations with the biotechnology business sector.Concerning genetic studies, we participate in collaborative projects to determine the genetic factors associated with risk of stroke and further neurological impairment. These studies will help us better understand which metabolic pathways are involved in this disease thus facilitating the creation of new drugs to treat stroke. We also investigate the genetic and epigenetic factors that influence drug response, aiming to select and customize treatments in the future. In these genetic studies samples of up to 450,000 people will be analysed from our participation in international consortia.Intracerebral haemorrhage is a minority subtype of stroke but it has a high rate mortality and disability. One of our goals is based on the identification of molecules directly involved in this disease and the identification of specific biomarkers that define the two main causes of primary intracerebral haemorrhage (arterial hypertension and Cerebral Amyloid Angiopathy (AAC)) and to develop new therapeutic strategies for this disease. In this sense, from VHIR, we are leading a nationwide multicentre study to deepen the research for radiological and biological markers of cerebrovascular dysfunction in AAC and using different approaches in vitro and in vivo to model the disease at a preclinical level.In the field of post stroke neurorepair we research in the implementation of new treatments for neurovascular remodelling in experimental models of cerebral ischemia, highlighting endothelial progenitor cell therapies or neurorehabilitation therapies. In collaboration with the Neurorehabilitation Unit of HUVH we initiated a cohort study in patients who have overcome a stroke but who receive rehabilitation treatment due to acquired functional disability, in which we study the modulation of cellular and molecular markers (study SMARTS). Recently this study has been extended to a multicentre level with the participation of 10 centres nationwide that also evaluate the benefits of intensive inpatient rehabilitation programs.