ASPECTS · Encéfalo

ASPECTS Alberta Stroke Program Early CT Score

vigente

A 10 point topographic score of early ischemic change in the middle cerebral artery territory on non-contrast CT.

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Escala de categorias

10 >=6 <6

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Procedência e vigência

Órgão emissor: Alberta Stroke Program
Versão: 2000
Ano: 2000
Família: léxico
Tipo de lógica: score
Modalidade: CT
Fonte primária: Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke (ASPECTS) · doi:10.1016/S0140-6736(00)02237-6
Última verificação: 2026-06-22
Última checagem: 2026-06-22

Lógica de decisão

Forma estruturada (score). Uma futura calculadora a lê; as categorias abaixo são a superfície legível.

Subtract one point per region with early ischemic change from a baseline of 10. Bands pending sourcing.

Mostrar a lógica estruturada (JSON)

{
  "feature_groups": [
    "mca_cortical_regions",
    "deep_structures"
  ],
  "points": null,
  "score_map": null
}

Categorias num relance

Cat.	Significado	Conduta	Risco	Fonte
10	Normal scan, no early ischemic change Top of the 10-point scale, meaning no early ischemic change is seen in any of the assessed regions of the middle cerebral artery (MCA) territory. ASPECTS is a 10-point topographic score: it starts at 10 and one point is deducted for each MCA-territory region showing early ischemic change (visible hypoattenuation) on non-contrast CT, so a score of 10 is a normal CT with no detectable early ischemia.	A high (normal) ASPECTS reflects little/no established core and is the favorable end of the range used to select patients for reperfusion therapy.	Higher baseline ASPECTS is associated with better 3-month functional outcome and lower risk of symptomatic intracerebral hemorrhage after thrombolysis.	okfonte Barber 2000 abstract (PMID 10905241): 'The score divides the middle-cerebral-artery territory into ten regions of interest'; 'Baseline ASPECTS value predicted functional outcome and symptomatic intracerebral haemorrhage' and 'correlated inversely with the severity of stroke on the NIHSS'. Scoring concept (hypoattenuation = early ischemic change) per Alqahtani 2023, Introduction.
>=6	Favorable, limited early ischemia An ASPECTS of 6 or higher denotes only limited early ischemic change (a relatively small infarct core). Per the fetched source, current American and European guidelines recommend mechanical thrombectomy for anterior-circulation large-vessel occlusion only in patients with an ASPECTS of 6 or more.	Within the conventional guideline-eligible band for mechanical thrombectomy in anterior-circulation large-vessel occlusion.	—	okfonte Alqahtani 2023 (PMC10104593, https://doi.org/10.7759/cureus.36194), Introduction: 'based on current American and European guidelines, this treatment only applies to patients with ASPECTS of 6 or more'
<6	Extensive early ischemic change A low ASPECTS (the fetched sources operationalize the low band as ASPECTS of 5 or less, i.e. <6) indicates a large area of hypoattenuation / large established ischemic core. Such a large core was traditionally considered to make thrombolytic or endovascular therapy less suitable because of higher treatment risk and limited salvageable tissue; large-core trials define large core as ASPECTS <=5.	Historically considered outside the standard thrombectomy window because of large core; the fetched literature notes this is being challenged and selected ASPECTS<=5 ('large-core') patients may still benefit from thrombectomy.	Low ASPECTS / large core carries higher risk of poor functional outcome and of edema/malignant infarction; per the large-core meta-analysis a low-ASPECTS large core is the higher-risk imaging stratum.	okfonte Alqahtani 2023 (PMC10104593), Introduction/Discussion: 'Low ASPECTS, indicating a large area of hypoattenuation, may make thrombolytic or endovascular therapy unsuitable... ASPECTS <= 5'. Sarraj 2026 ATLAS abstract (PMID 42107392): 'large-core ischaemic stroke (based on an ASPECTS of <=5 or estimated ischaemic core >=50 mL)'.

Histórico de versões

Data	Evento	Detalhe	Situação
2000-05-13	published	ASPECTS validated in the Lancet.	confirmado

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