We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Patients are the centre and the core of our system. We are professionals committed to quality care and our organizational structure breaks down the traditional boundaries between departments and professional groups, with an exclusive model of knowledge areas.
Would you like to know what your stay at Vall d'Hebron will be like? Here you will find all the information.
The commitment of Vall d'Hebron University Hospital to innovation allows us to be at the forefront of medicine, providing first class care adapted to the changing needs of each patient.
These syndromes are a group of diseases characterised by insufficient blood cell production (anaemia, neutropenia and thrombocytopenia), constitutional malformations and the risk of cancer.
They are usually diagnosed in childhood but there some cases diagnosed in adults. Specifically, these syndromes are: Fanconi anaemia, dyskeratosis congenita or selectively severe congenital neutropenia, Diamond-Blackfan anaemia, Diamond-Shwachman syndrome, and amegakaryocytic thrombocytopenia.
Malformations caused by inherited bone marrow failure syndromes affect the skin, bones, heart and digestive system as well as the urinary system, the central nervous system, and others. They may also affect the area around the bone marrow.
Besides this, they also increase the predisposition to cancers such as acute myeloid leukaemia, myelodysplastic syndrome and squamous carcinoma of the head, neck and reproductive organs.
These syndromes have important biological pathways in common related to cell growth and division such as the activation of the p53 gene that is responsible for halting the cell cycle, cell ageing and cell death. In addition, mutations have been identified in more than 80 genes.
Although this is treated in childhood, once the patient reaches adulthood monitoring is very important. Early diagnosis of these syndromes is essential to ensure the patient receives appropriate treatment. The aim is to minimise toxicity at the same time as allowing genetic counselling, and implementing strategies for cancer prevention and monitoring. This treatment should focus on treating the bone marrow failure, but also any constitutional malformations and extra-haematological manifestations, in addition to cancer treatment.
A multidisciplinary team of specialists with extensive experience of these diseases is necessary to ensure optimum patient care.
The first symptoms are related to a lack of blood cell production:
There are also signs related to malformations such as:
Estimated incidence rates of the different syndromes are:
The usual tests to detect inherited bone marrow failure are:
The following methods are used to treat these pathologies:
To prevent these diseases it is important to avoid smoking, alcohol, sun exposure, and to have a balanced diet. In addition, a cancer prevention programme should be followed with regular visits to the Cancer Prevention Unit and the Ear, Nose and Throat, Maxillofacial and Gynaecology departments.
Osteoarthritis is a condition that causes the cartilage developed by the bones to protect them from the wear caused by using the knee to break down. Once this deterioration has started, it develops progressively. At advanced stages of the condition, this breakdown causes pain and prevents patients from walking or standing normally. There are currently no medications to halt the breakdown at this stage.
When the pain cannot be managed with the usual painkillers, total knee replacement surgery is required, also known as arthroplasty.
The aims of knee replacement surgery are to:
During surgery, joint surfaces that are missing cartilage are replaced by an artificial implant made of chrome, cobalt or titanium.Once the affected part has been removed, the metal implant is put into place and fixed to the bone using cement.
At Valld’Hebron Hospital, we perform up to 500 knee replacement operations a year.
Stroke treatment requires immediate care in specialized units by expert neurologists. Early intervention reduces mortality and long-term disability, and accurately identifying the onset time of symptoms is essential.
In the case of ischemic strokes, the purpose of treatment is to undo or remove, in the shortest possible time, the clot that is cutting off the natural blood circulation in the brain. There are two ways to do this:
In haemorrhagic strokes, the treatment aims to stop the bleeding that has been caused by the rupture of a vessel and prevent the increase in size of the haemorrhage. Therefore, regular monitoring of the patient is performed to gauge the level of consciousness and any neurological deficits. This is maintained for at least the first 72 hours after suffering a stroke. We also perform intensive monitoring of blood pressure, blood sugar levels and temperature to foresee possible complications.
Brain bleeding can cause inflammation of the surrounding brain tissue (known as oedema). If this happens, it is necessary to administer medication intravenously to reduce it. In people who are being treated with oral anticoagulants or who have alterations in haemostasis (a process that the body performs to slow down bleeding), it should be corrected as soon as possible.
In more severe cases, specialists may recommend surgery to drain the bleeding. The decision on surgical treatment is made based on factors such as the location and size of the haemorrhage, age, and the patient’s medical history. This is a difficult decision as it is not always possible to access it without causing damage to other areas of the brain.
The purpose of neurorehabilitation is to regain lost or diminished neurological functions as a result of a stroke. However, there are phases of recovery:
The interdisciplinary team involved throughout the different stages works so that the patient has the maximum independence and adaptation to their environment. To meet these goals, it is advisable to start recovery as soon as possible and, from the initial stages, foster the participation of patient and caregivers.
It should be mentioned that there is “Spontaneous recovery”: this is when the brain has the ability to recover from the damage it has suffered on its own. This recovery, however, may not be enough to reduce the sequelae. That is why it is advisable to always follow the instructions of specialists.
An interdisciplinary team deals with the recovery of a patient who has suffered a stroke. Each of the professionals acts according to the evolution of the condition and the needs that arise at any given time:
Other professionals such as doctors, nurses and orthopaedic technicians are also involved in the rehabilitation process.
In this disease, which has no symptoms, the most important thing is the prevention of its most dreaded complication, fractures. Both treatment and prevention must be supervised by a primary care doctor or specialist.
To prevent osteoporosis and the risk of fracture, a diet rich in calcium, magnesium, and vitamin D, found in legumes, avocados, and nuts, is recommended.
If you don't get enough calcium in your diet, taking supplements may be necessary. The National Osteoporosis Foundation recommends a daily calcium intake of 1000 mg for most adults and 1200 mg for women over 50 and men over 70.
This vitamin is important to help the body absorb calcium from the foods we eat. The recommended daily dose is between 400 and 800 international units (IUs) for adults under 50, and 800 to 1000 IUs for those over 50. These are the current guidelines from the National Osteoporosis Foundation. You may need a different dose, depending on the levels of vitamin D in your blood, sometimes up to 50,000 units per week for 12 weeks.
There are also medications containing antiresorptive or bone-forming agents, such as bisphosphonates, parathyroid hormone (PTH), monoclonal antibodies, and others, which can be prescribed by a doctor based on a patient's comorbidities (what other disorders or diseases they have) and preferences.
Doing a moderate physical activity with some impact is recommended, such as jumping, walking, or dancing, along with other activities like yoga and tai chi, which have additional benefits when it comes to preventing falls and fractures.
Exercise slows muscular atrophy, improves joint mobility, directly promotes bone formation, and improves neuromuscular coordination.
The rehabilitation specialist is one of the people in charge of advising the family and the patient about treatment. The rest of the orthopaedic team and the team physiotherapist at the hospital will monitor the progression of this deformity. There are several different treatments for scoliosis, the use of which depends on the type, curvature, and the patient’s age.
The most negative consequence of scoliosis is that it can affect pulmonary function. To avoid this and aesthetic changes, different treatments are used.
In growing children and adolescents, a conservative treatment is used; its aim is to prevent the progression of the curve. The curvature is monitored via observation and a corrective brace is applied if the curve has reached 25 degrees. This brace reduces the risk that the curve will progress, corrects the deformity, and reduces the need for surgery.
To treat small curves that are at low risk of progression, physiotherapy is recommended.
Curves of less than 20 degrees should not be treated, and those above this angular value should meet a number of requirements:
It is important that the whole team, the patient, and the family understand and accept the treatment, that regular follow-up visits are adhered to, and that everyone works together to comply with the treatment plan.
The aim of surgery is to correct and maintain the curvature. Other objectives would be to improve the individual's appearance by balancing the torso and reducing short and long-term complications to a minimum. Surgery will be considered in the following cases:
If the patient requires surgical treatment, the team of expert traumatology surgeons at the Spinal Unit will be in charge of continuing with this process.
Childhood dystonia is progressive and debilitating, but it can be prevented with an early diagnosis and the use of specific therapies that target the genetic defect identified. Currently, several different treatments are used.
Levodopa trial
In children with isolated dystonia, a one to three-month long trial with levodopa must always be carried out. This medication can completely reverse symptoms when the dystonia is caused by a defect in dopamine synthesis. This is called dopa-responsive dystonia.
Such defective dopamine synthesis can be caused by alterations in the genes and proteins that regulate dopamine metabolism. This neurotransmitter is essential in learning, behaviour, and motor function.
Treatment with botulinum toxin
Botulinum toxin is effective at controlling focal dystonia, which affects a muscle group carrying out a specific action, such as, for example, writer’s cramp, or dystonia triggered by walking, treatment for which consists of correcting the abnormal foot or leg position when walking.
In children with generalised dystonia, botulinum toxin can also relieve pain in muscle groups that are particularly affecting the patient’s quality of life.
Treatment with various pharmaceuticals
To treat generalised dystonia in children, different drugs are administered to reduce the tremors, muscle tone, and painful spasms. These include benzodiazepines, GABA antagonists (baclofen), anticholinergics, and α-2 adrenergic receptor agonists. In some patients with paroxysmal dystonia, which is characterised by brief, repetitive involuntary movements at night, anti-epileptics are prescribed.
Intrathecal baclofen pump
When oral medications are not enough, there is a surgical option: the intrathecal baclofen pump. This internal device administers the medication baclofen through a catheter placed in the epidural space (which contains the liquid that surrounds the spinal cord). This helps control generalised dystonia, reducing pain, muscle tone, and spasms and thus improving patients’ quality of life.
This device is used to treat secondary dystonia or dystonia associated with other neurological problems (whether neurometabolic, neurodegenerative, or acquired through brain damage at birth).
Deep brain stimulation or pallidal stimulation
This consists of placing two electrodes in the pallidal nuclei of the brain via a stereotactic procedure, to improve the patient’s motor function and quality of life. Patients who are candidates for pallidal stimulation are those with primary dystonia who have no structural brain lesions in the central nervous system.
The department is made up of professionals from the Catalan Health Institute (ICS) and the Institute for Diagnostic Imaging (IDI). We use the most advanced techniques and help generalise their application to improve patient care and the quality of diagnostic and therapeutic examinations.
The Radiodiagnosis Department offers a wide range of examinations. Requests are analysed to establish their suitability, and a standard individualised study protocol for each clinical situation is assigned. Protocols are revised and updated regularly to ensure the quality and relevance of the studies. The department is organised into sections, following an “Organ and System” structure, which means we are properly integrated into the rest of the hospital, ensuring a high degree of specialisation in each area:
The mission of the Neurosurgery Department is to guarantee excellence in care, education and research, with an international outlook. We have a particular focus on the needs and preferences of patients with diseases of the nervous system that require surgical treatment.
At the Neurosurgery Department, we apply the most advanced technologies and a multidisciplinary approach in a context that allows us to train neurosurgeons with strong ethical and moral values. All this, as part of the public health system that is accessible to all citizens.
The locomotor system, also known as the musculoskeletal system, consists of a person’s bones, muscles, joints, tendons and ligaments. It is a highly structured system whose purpose is to move and support the rest of the body's structures. Rheumatology deals with disorders and diseases of the musculoskeletal system and connective tissue. It is a very wide-reaching speciality that covers almost 200 diseases.
The Vall d’Hebron University Hospital's Rheumatology Service is an adult and paediatric care service for patients with rheumatic illnesses. It serves a reference population of 450,000 inhabitants and 18 primary care centres in the AIS Nord area. We work in the hospital environment and in primary care, and outpatient activity is clearly predominant.
Guia o itenerari formatiu (GUIF) - CAS - Reumatologia
At the Spinal Cord Injury Unit, part of the Rehabilitation and Physical Medicine Department, we offer comprehensive care to patients with acute spinal cord injury and pathologies derived from chronic spinal cord injury, such as pressure wounds, acute respiratory failure, urinary infections with sepsis, autonomic dysreflexia, among others.
At the Spinal Cord Injury Unit, we seek to treat people with spinal cord injuries in order to alleviate the related disability and, therefore, improve the quality of life, health and social participation of patients. Here, patients receive comprehensive care for all the deficiencies and disabilities that can be caused by a spinal cord injury.
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