globe.1 The WHO reported an excess of total stroke-related deaths among women compared with men between 1990 and 2006, of which 60% occurred in those aged over 75 years.42 A study performed in 8 different European countries found that the risk of stroke increased by 9% per year in men and 10% per year in women.43 This increased risk may be partly explained by the longer lifespan of women compared with men, and by the fact that hypertension and atrial fibrillation, key risk factors for stroke, are more frequent in women than in men.44 But further differences in vascular biology, immunity, coagulation, hormonal profiles, lifestyle factors, and societal roles seem to contribute, especially due to risks related to pregnancy and the postpartum state.44 Conclusion In conclusion, in the last decades, a substantial decrease of stroke incidence, mortality, and DALYs has been achieved in high-income countries, most likely due to improvement in primary and secondary prevention as well as acute stroke treatment and neurorehabilitation. However, stroke remains an important cause of disability and death worldwide. Globally, the burden of stroke has increased substantially over the past few decades due to expanding population numbers and aging as well as the increased prevalence of modifiable stroke risk factors, especially in low- and middleincome countries. The number of patients who will need care by clinicians with expertise in neurological conditions will continue to grow in the coming decades.2 Disclosures None. References 1 Mortality GBD; GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016;388(10053):1459–1544 2 Group GBDNDC; GBD 2015 Neurological Disorders Collaborator Group. Global, regional, and national burden of neurological disorders during 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Neurol 2017;16(11):877–Current Advances, Challenges, and Opportunities in Stroke Research, Management, and Care Abstract Stroke is the second leading cause of death (after heart disease) and a major cause of disability worldwide. Also called a brain attack, typical symptoms of stroke include sudden one-sided weakness and numbness in the face and arm as well as altered speech. Most strokes are ischaemic strokes where arterial blood flow to the brain is interrupted by an embolism or thrombosis. Strokes are less frequently caused by haemorrhage. Non-contrast cranial computed tomography (CT) imaging, the workhorse of acute stroke diagnosis, can reliably differentiate between ischaemic stroke and intracerebral haemorrhage. Contrast CT imaging – including angiography, perfusion and magnetic resonance imaging (MRI) – can be used to detect large vessel occlusions and to identify ischaemic brain tissue that can still be salvaged by reperfusion. Treatment of acute ischaemic stroke focuses on the rapid reperfusion of brain tissue by means of intravenous thrombolysis and endovascular thrombectomy to salvage the at-risk tissue surrounding the infarct core. Reperfusion therapy is followed by specialised multidisciplinary stroke unit care and rehabilitation, all of which increases the chance of survival and reduces long-term disability. The mainstay of acute haemorrhagic stroke treatment in hypertensive patients is a lowering of blood pressure to stop haematoma expansion. Selected patients benefit from haemostatic agents or surgical treatment. Prevention of recurrent strokes includes lifestyle modifications and therapeutic interventions to control hypertension, hyperlipidaemia, diabetes, and smoking. Specific interventions to prevent recurrent strokes depend on the underlying stroke aetiology. These include antithrombotic medication, anticoagulation for atrial fibrillation, carotid endarterectomy or stenting, and the closure of a patent foramen ovale in ischaemic stroke patients. General Lay Summary Stroke is the second leading cause of death worldwide and a major cause of disability. It leads to a considerable loss of years of life and enormous social and economic costs. Diagnosis and treatment of stroke is thus an important field of research. Typical symptoms of stroke include sudden onset of unilateral weakness and numbness in the face and arm as well as altered speech. In ischaemic strokes, the arterial blood supply to the brain is interrupted by an embolism or thrombosis. Less frequently, strokes are caused by bleeding in the brain. Imaging techniques, especially computed tomography (CT), can reliably distinguish between an ischaemic stroke and a haemorrhage. CT scans with contrast medium can locate large vessel occlusions and identify brain tissue that can still be saved by restored blood flow. The treatment of an acute ischaemic stroke then focuses on the rapid reperfusion of the affected brain tissue. For this purpose, vascular occlusions are dissolved with medication or surgically removed. Further treatment in a specialised stroke unit and rehabilitation increase the patient's chances of survival and reduce permanent impairments. A stroke caused by bleeding is treated in hypertensive patients by lowering blood pressure to prevent the