Alberta stroke program early CT score ( ASPECTS)

What is Alberta stroke program early CT score?

Dr Owen Kang and Dr Haris Sair et al.

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 the MCA vascular territory is made and 1 point is deducted from the initial score of 10 for every region involved:

• caudate
• putamen
• 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"

Important points

1. 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
2. M1 to M3 are at the level of the basal ganglia
3. M4 to M6 are at the level of the ventricles immediately above the basal ganglia

Clinical use

An ASPECTS score less than or equal to 7 predicts worse functional outcome at 3 months as well as symptomatic haemorrhage.
According to study done by R.I Aviv et al ³ patients with ASPECTS score less than 8 treated with thrombolysis did not have a good clinical outcome.