The Alberta stroke programe early CT score (ASPECTS) is a 10-point quantitative topographic CT scan score used in patients with middle cerebral artery (MCA) stroke. Segmental assessment of MCA territory is made and 1 point is removed from the initial score of 10 if there is evidence of infarction in that region.
- internal capsule*
- insular cortex
- M1 : "anterior MCA cortex," corresponding to frontal operculum
- M2 : "MCA cortex lateral to insular ribbon" corresponding to anterior temporal lobe
- M3 : "posterior MCA cortex" corresponding to posterior temporal lobe
- M4 : "anterior MCA territory immediately superior to M1"
- M5 : "lateral MCA territory immediately superior to M2"
- M6 : "posterior MCA territory immediately superior to M3"
(M1 to M3 are at the level of the basal ganglia and M4 to M6 are at the level of the ventricles immediately above the basal ganglia)
An ASPECTS score less than or equal to 7 predicts worse functional outcome at 3 months as well as symptomatic haemorrhage.
*in the initial paper, it specifically refers to the posterior limb, however subsequent articles indicate any portion of the internal capsule may be counted
- 1. Barber PA, Demchuk AM, Zhang J, Buchan AM. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Alberta Stroke Programme Early CT Score. Lancet 2000 May 13;355(9216):1670-4
- 2. Pexman JH, Barber PA, Hill MD, Sevick RJ, Demchuk AM, Hudon ME, Hu WY, Buchan AM. Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke. AJNR Am J Neuroradiol. 2001 Sep;22(8):1534-42
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