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.
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CONCLUSIONS: Interrater agreement for medium-vessel occlusions is moderate when using single-phase CTA and almost perfect with multiphase CTA. Detection accuracy is substantially higher with multiphase CTA compared with single-phase CTA, suggesting that multiphase CTA might be a valuable tool for assessment of medium-vessel occlusion stroke.
CONCLUSION: In light of the recent direct-to-EVT trials, a sizeable proportion of stroke physicians appears to be rethinking IVT treatment strategies of EVT-eligible mothership patients with AIS due to LVO in specific situations.
CONCLUSIONS AND RELEVANCE: In this study, discrepancies between functional outcome and post-EVT infarct volume were associated with differences in pretreatment factors, such as age and comorbidities, and posttreatment complications related to index stroke evolution, secondary prevention, and quality of stroke unit care. Besides preventing such complications, optimization of blood pressure, glucose levels, and hemoglobin levels are potentially modifiable factors meriting further study.
CONCLUSIONS: Physicians' willingness to treat secondary medium vessel occlusions endovascularly is limited and varies per occlusion location and change in neurologic status. More evidence on the safety and efficacy of endovascular treatment for secondary medium vessel occlusion stroke is needed.