The Alberta stroke programme early CT score (ASPECTS) 1 is a 10-point quantitative topographic CT scan score used in patients with middle cerebral artery (MCA) stroke. Segmental assessment of the MCA vascular territory is made and 1 point is deducted from the initial score of 10 for every region involved:
- 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"
- the initial paper 1 specifically referred to the internal capsule only involving the posterior limb, however, subsequent articles indicate any portion of the internal capsule may be included
- M1 to M3 are at the level of the basal ganglia
- M4 to M6 is at the level of the ventricles immediately above the basal ganglia
An ASPECTS score less than or equal to 7 predicts a worse functional outcome at 3 months as well as symptomatic haemorrhage.
According to the study performed by R. I. Aviv et al., patients with ASPECTS score less than 8 treated with thrombolysis did not have a good clinical outcome 3.
- 1. Barber PA, Demchuk AM, Zhang J et-al. 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;355 (9216): 1670-4. Pubmed citation
- 2. Pexman JH, Barber PA, Hill MD et-al. Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke. AJNR Am J Neuroradiol. 2001;22 (8): 1534-42. Pubmed citation
- 3. Aviv RI, Mandelcorn J, Chakraborty S et-al. Alberta Stroke Program Early CT Scoring of CT perfusion in early stroke visualization and assessment. AJNR Am J Neuroradiol. 2007;28 (10): 1975-80. doi:10.3174/ajnr.A0689 - Pubmed citation
- 4. Puetz V, Dzialowski I, Hill MD et-al. The Alberta Stroke Program Early CT Score in clinical practice: what have we learned?. Int J Stroke. 2009;4 (5): 354-64. doi:10.1111/j.1747-4949.2009.00337.x - Pubmed citation