From the case:
Middle cerebral artery territory in ASPECTS study
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A. CT Axial slice at the level of thalamus and basal ganglion which includes 4 deep and 3 cortical territories.
B. CT Axial slice at the level adjacent to the most superior margin of the ganglionic structures which includes 3 cortical MCA territories.
Case Discussion
A. CT axial slice at the level of the thalami and basal ganglia 1 (Includes 4 deep* and 3 cortical territories):
- C - caudate head*
- LN - lentiform nucleus*
- IC - internal capsule*
- I - insular cortex*
- M1 - anterior MCA cortex
- M2 - MCA cortex lateral to the insular ribbon
- M3 - posterior MCA cortex
("A" - anterior circulation, "P" - posterior circulation)
B. CT axial slice at the level adjacent to the most superior margin of the ganglionic structures 1 (Includes 3 cortical territories):
- M4, M5, M6 - anterior, lateral and posterior MCA territories, respectively (approximately 2 cm superior to M1, M2 and M3 respectively)
Practical points:
- total of 10 MCA territories are defined, where each area equals to 1 point 1
- normal CT scan received an ASPECTS of 10 points 1
- a score of <7 is equal to one-third of the MCA territory 1
- a score of zero indicates diffuse ischemia involvement throughout the MCA territory 1
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