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.
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.
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.
The score was developed in consideration of a multitude of imaging data of patients who presented with symptoms of acute stroke with proven vascular occlusion. The scale is used in clinical trials worldwide to quantify and classify the extent of early ischemic changes on a quantitative scale.
Cited in stroke journals and publications as the standardized means of communication of early ischemic changes, the ASPECTS is used in a multitude of articles and scientific journals.
A simple score used to communicate findings of a life-threatening and potentially disabling condition, ASPECT Score could be used in a multitude of resource settings and on most basic scanners worldwide to accurately detect and quantify early ischemic changes in acute stroke.
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.
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.
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.
Overall, positive outcomes for patients increased from 30 per cent to 55 per cent. In many cases, instead of suffering major neurological disability, patients went home to resume their lives. The overall mortality rate was reduced from two in 10 patients for standard treatment of care to one in 10 patients – a 50 per cent reduction with EVT.
The clinical trial, known as ESCAPE (Endovascular treatment for Small Core and Anterior circulation Proximal occlusion with Emphasis on minimizing CT to recanalization times), shows there is a marked reduction in both disability and death among patients who receive EVT for acute ischemic stroke. Ischemic stroke is caused by a sudden blockage of an artery to the brain that deprives the brain of critical nutrients, such as glucose and oxygen. Currently, the international standard of care based on Canadian, U.S. and European guidelines is to administer a drug called tPA when appropriate. Known as a ‘clot buster’, the drug dissolves the blood clot.
In the ESCAPE trial, 316 patients who fit the criteria for EVT and arrived for treatment within 12 hours of their stroke were randomized to standard medical care (which included the clot-busting drug tPA where appropriate) or standard medical care plus EVT.
ET is performed by inserting a thin tube into the artery in the groin, through the body, and into the brain vessels to the clot. This is done under image-guided care using an X-ray. The clot is then removed by a retrievable stent and pulled out, restoring blood flow to the brain.
Endovascular treatments were first developed in the 1990s, but EVT has only recently been technically possible. The ESCAPE team says the success of the trial can be credited to very fast treatment and the use of brain and blood vessel imaging. In ESCAPE, researchers were on average two hours faster in opening the blocked blood vessels than in previously reported trials.
ESCAPE is the second EVT trial that demonstrates the efficacy of the treatment and the first trial to demonstrate reduced mortality. The previous trial, known as MR. CLEAN (Multi center Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands), was published in December 2014.
Here are some highlights as to what makes the ASPECT score reliable and applicable!