Temple University Hospital (TUH) is ideally suited to be a Neurological Emergency Treatment Trials (NETT) Clinical Site Hub. As the Hub, TUH with its three satellite hospitals, Temple Children's Medical Center, Northeastern, and Episcopal Hospitals and Hahnemann University Hospital (HUH) will form Phila-NETT, a consortium to effectively perform clinical studies related to neurological emergencies. Located in a low- income area of North Philadelphia, Phila-NETT sites serve a diverse population with a significant number of African American and Latino patients. TUH is one of the busiest Trauma centers in the state. Also, in part due to its open door policy of accepting both adult and pediatric patients from outside facilities and in part to the inaccessibility of Neurosurgical care in key counties surrounding Philadelphia, TUH provides treatment for a tremendous number of patients with neurological and neurosurgical emergencies. Dr. Gentile has had a career-long commitment to neurological emergencies research and has been active in both translational and clinical research in global hypoxia, traumatic brain injury and stroke. At TUH and HUH, specialists in Neurology, Neurosurgery, Pediatrics, Trauma, and adult and pediatric Neuro-critical care have primary services and provide high quality, consistent care. Central to the Phila-NETT program is a web based informatics system. Each participating site uses unique user identification to enter patients' information. The system immediately notifies researchers of potential study patients and dedicated clinical research nurses (CRN), well adept to different study protocols, are available 24/7 to screen and enroll patients at any PHILA-NETT site. Our CRNs bilingual, certified as emergency nurses, and extensively trained in neurologic assessment scales. The informatics system being used will trend data entry and will be used to provide feedback to ambulance personnel, community physicians, and critical care nurses on current best practices. Developing a coordinated approach to the study of neurological emergencies is an asset to the people of North Philadelphia. The communities served by our hub and spoke hospital sites will have access to higher levels of quality patient care and the opportunity to participate in cutting edge neurological research. In addition Phila-NETT's community education component will focus on primary and secondary disease prevention with the hope of decreasing the incidence of acute neurological emergencies. ?