ASPECTS Calculator for Stroke
Click on the involved areas to calculate the score.
ASPECTS for MCA
pc-ASPECTS for the Posterior Circulation
Calculated pc-ASPECT score: 10
References:
- 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
- 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
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More about the ASPECTS Calculator:
The Alberta Stroke Program Early CT Score (ASPECTS) is a 10-point quantitative scoring system developed to assess early ischemic changes in patients with acute ischemic stroke, particularly within the middle cerebral artery (MCA) territory. This tool aids clinicians in evaluating the extent of cerebral infarction on non-contrast CT scans, thereby informing treatment decisions and prognostication.
Purpose and Scope
ASPECTS is designed for use in adult patients presenting with symptoms of acute ischemic stroke. By systematically evaluating specific regions of the brain for early signs of ischemia, the score helps determine the severity of the stroke and guides therapeutic interventions such as thrombolysis or mechanical thrombectomy.
ASPECTS Scoring Methodology
The ASPECTS divides the MCA territory into ten distinct regions: the caudate nucleus, lentiform nucleus, internal capsule, insular cortex, and six cortical regions labeled M1 through M6. Each region is assigned one point if it appears normal. For every region showing early ischemic changes, one point is subtracted from the total score of 10. Thus, a score of 10 indicates no visible ischemic changes, while a score of 0 suggests extensive ischemia throughout the MCA territory.
Clinical Application
ASPECTS is utilized to:
- Quantify the extent of early ischemic changes on CT scans.
- Predict functional outcomes and risk of hemorrhagic transformation.
- Guide eligibility for reperfusion therapies, including intravenous thrombolysis and endovascular thrombectomy.
Studies have demonstrated that patients with higher ASPECTS (≥8) are more likely to benefit from reperfusion therapies and have better functional outcomes, whereas lower scores (≤7) are associated with increased risk of poor outcomes and symptomatic intracerebral hemorrhage.
Limitations
While ASPECTS provides a standardized approach to assessing early ischemic changes, it has limitations:
- Interobserver variability can affect scoring consistency.
- It may underestimate the extent of infarction in certain cases, especially in the posterior circulation.
- It is less sensitive in detecting small or subtle ischemic changes.
Despite these limitations, ASPECTS remains a valuable tool in the acute assessment of ischemic stroke and is widely used in both clinical practice and research settings.
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