We propose the Southern New England Partnership In Stroke Research, Innovation and Treatment (SPIRIT), a StrokeNet Regional Coordinating Center (RCC) anchored by 3 leading institutions: Yale School of Medicine, the Warren Alpert School of Medicine at Brown University, and Hartford Hospital. Each Hub is a Comprehensive Stroke Center with 14 total Primary Stroke Centers. Yale is the 7th largest hospital in the United States, and in collaboration with Brown and Hartford Hospital, and their respective networks, SPIRIT captures a diverse geographic area that provides access to 5.7 million people, including most adult and pediatric stroke patients in Connecticut and Rhode Island. This robust patient volume (over 3500 total stroke patients in 2016), combined with an exceptionally strong collaborative and organizational framework, gives SPIRIT great potential for clinical trial implementation. Principal Investigators Dr. Kevin N. Sheth (Yale), Dr. Karen Furie (Brown), and Dr. Mark Alberts (Hartford Hospital) bring a complementary set of leadership and high-level clinical trials experience in stroke. Each leader brings well recognized expertise in international multicenter studies and implementation of stroke systems of care, as well as a track record of high quality stroke trial recruitment and retention. In various capacities, they have worked together for over 12 years, and each PI leads an enthusiastic cadre of faculty across disciplines, to create a highly collaborative environment focused on stroke research, multicenter trials, membership on Institutional Review Boards, clinical trial committees, and extensive mentoring in patient-oriented research. SPIRIT maintains strong connections to NIH funded CTSA networks and is further strengthened by the following characteristics: 1) A pool of talented investigators with nationally recognized clinical and translational research expertise in stroke; 2) Rich diversity (both ethnic/racial as well as urban/rural) of patients in Southern New England currently not captured by the existing StrokeNet network; 3) Active leadership and participation in stroke communities and stroke systems of care in the areas of statewide policy, continuity of care, American Heart Association collaborations and regional education; 4) Deep investigator and patient pools for all three areas of StrokeNet initiatives – prevention, acute treatment, and recovery; 5) Access to a range of specialized tools already harmonized across centers including a common electronic medical record system (EPIC) and RAPID software for acute stroke imaging, enhancing data sharing and collaboration; 6) Continuous commitment from all three institutions to the central IRB model and use of a Master Trial Agreement; 7) Rich science core with ongoing NIH funded stroke studies and multiple, active StrokeNet proposals currently under review; and 8) An education core designed to identify, support and accelerate the development of tomorrow's stroke investigators. Th...