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ASPECT Score for

Assessment in Acute Stroke

  • Alberta Stroke Program Early CT score (ASPECTS) is a 10-point quantitative score used to assess early ischemic changes on non-contrast CT head.
  • ASPECTS is intended to provide a reliable and reproducible grading system on non-contrast CT examinations of the head for detection of early ischemic changes in patients suspected of having acute large vessel anterior circulation occlusion. It is used as part of the assessment for eligibility in receiving interventional mechanical thrombectomy treatment.
  • ASPECTS score is a simple and reliable tool for detection of early ischemic changes on non-contrast CT scans of the brain.


Easily Applicable

Easily Applicable

Based on the Plain/Non-contrast CT Head. The ASPECT Score can be used to assess early ischemic changes in acute stroke on any modern CT scanner without the need for additional processing steps making it easily applicable in many settings worldwide.

Imaging Based

Imaging Based

As the initial imaging modality to both screen for and establish the diagnosis of acute stroke, the ASPECT Score provides an opportunity to quantify the degree of ischemic changes in the brain parenchyma and serve as the basis for subsequent decision making. 

Easily Communicated

Easily Communicated

A score out of 10, the ASPECT Score is an easy and widely understood means of communicating the extent of ischemic changes amongst care teams and physicians.

Learn to Calculate the ASPECT Score:

ASPECTS Training Course and Certificate Info:

The educational modules (EdModules) will take you through basics of the clinical presentation, imaging, and initial assessment of acute stroke on CT scans with insights on how to determine early ischemic changes and the ASPECT Score. Subsequent modules will focus on multiphase CTA (mCTA)  and assessment of the collateral circulation

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    Latest Research and Publications:

    Time of day and endovascular treatment decision in acute stroke with relative endovascular treatment indication: insights from UNMASK EVT international survey.

    Icon for HighWire Related Articles

    Time of day and endovascular treatment decision in acute stroke with relative endovascular treatment indication: insights from UNMASK EVT international survey.

    J Neurointerv Surg. 2020 Feb;12(2):122-126

    Authors: Ospel JM, Kashani N, Goyal M, Menon BK, Campbell BCV, Fischer U, Turjman F, Mitchell P, Yoshimura S, Podlasek A, Rabinstein AA, Wilson AT, Kim BM, Baxter BW, Cherian MP, Heo JH, Foss M, Demchuk AM, Sylaja PN, Hill MD, Saposnik G, Almekhlafi MA

    BACKGROUND AND PURPOSE: The decision to proceed with endovascular thrombectomy should ideally be made independent of inconvenience factors, such as daytime. We assessed the influence of patient presentation time on endovascular therapy decision making under current local resources and assumed ideal conditions in acute ischemic stroke with level 2B evidence for endovascular treatment.
    METHODS AND MATERIALS: In an international cross sectional survey, 607 stroke physicians from 38 countries were asked to give their treatment decisions to 10 out of 22 randomly assigned case scenarios. Eleven scenarios had level 2B evidence for endovascular treatment: 7 daytime scenarios (7:00 am-5:00 pm) and four night time cases (5:01 pm- 6:59 am). Participants provided their treatment approach assuming (A) there were no practice constraints and (B) under their current local resources. Endovascular treatment decisions in the 11 scenarios were analyzed according to presentation time with adjustment for patient and physician characteristics.
    RESULTS: Participants selected endovascular therapy in 74.2% under assumed ideal conditions, and 70.7% under their current local resources of night time scenarios, and in 67.2% and 63.8% of daytime scenarios. Night time presentation did not increase the probability of a treatment decision against endovascular therapy under current local resources or assumed ideal conditions.
    CONCLUSION: Presentation time did not influence endovascular treatment decision making in stroke patients in this international survey.

    PMID: 31285376 [PubMed - indexed for MEDLINE]