ASPECTS

Barber PA, Demchuk AM, Zhang J, Buchan AM. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Introduced the 10-point topographic CT score; a baseline ASPECTS ≤ 7 predicted worse functional outcome and symptomatic haemorrhage after intravenous thrombolysis.

AHA/ASA acute ischaemic stroke guidelines and the endovascular trials (HERMES pooled analysis) support mechanical thrombectomy for large-vessel occlusion with ASPECTS ≥ 6 in the early window; later trials (SELECT2, ANGEL-ASPECT) extended benefit to selected patients with ASPECTS 3–5. ASPECTS should be read on non-contrast CT by trained observers and correlated with clinical severity and time from onset.