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Neurology
ASPECTS Score

ASPECTS Score — Alberta Stroke Program Early CT

10-point topographic CT scoring of early ischaemic change in MCA territory

Instructions: Check each region that appears NORMAL (no early ischaemic change). Score starts at 10; 1 point is subtracted for each area with early ischaemia.
Live ASPECTS Score
10
Normal
10/10 normal
Subcortical Structures
Cortical MCA Territory
—
ASPECTS / 10
Affected Regions: None
Recommendation: —
ASPECTS Interpretation
ScoreInterpretationImplication
10Normal CTExcellent reperfusion candidate
8–9Minor ischaemic changesGood candidate for reperfusion
7Moderate changesReperfusion may still benefit
≤6Poor prognosisSuboptimal for thrombolysis
≤5Extensive ischaemiaConsider carefully; poor outcome likely
Start at 10 points; subtract 1 for each MCA region with early ischaemic change
Ischaemic change = hypodensity, loss of grey-white differentiation, or sulcal effacement
Score assessed on unenhanced CT within 6h of onset (ideally)
Thrombectomy Context: DAWN/DEFUSE-3 trials selected patients with core infarct <70mL (roughly ASPECTS ≥6). ASPECTS <6 on non-contrast CT often excludes patients from routine thrombectomy. Some centres use ASPECTS ≥7 as threshold for IV tPA eligibility.
For clinical decision support only. Not a substitute for professional medical judgment.

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