# ASPECTS — Alberta Stroke Program Early CT Score

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

**Situação:** vigente · **Órgão:** Encéfalo · **Órgão emissor:** Alberta Stroke Program · **Versão:** 2000 · **Ano:** 2000

## Procedência e vigência
- Família: léxico
- Tipo de lógica: score
- Modalidade: CT
- Fonte primária: Barber PA, Demchuk AM, Zhang J, Buchan AM. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke (ASPECTS) (2000) — https://doi.org/10.1016/S0140-6736(00)02237-6
- Última verificação: 2026-07-24
- Última checagem: 2026-07-24

## Lógica de decisão
Calculate and report the exact 0-10 score plus involved regions and modality. The legacy RadCommons outcome bands are interpretive outputs; current EVT selection requires the additional variables encoded in EVT_2026_context.

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| 10 | Normal scan, no early ischemic change | Exact ASPECTS 10: no early ischemic change in any of the ten assessed regions of the affected middle cerebral artery territory on noncontrast CT. Start at 10 and subtract one point for each involved region: C, L, IC, I, and M1-M6. | ASPECTS 10 alone neither mandates nor excludes reperfusion. For ICA or M1 large-vessel occlusion with NIHSS at least 6 and prestroke mRS 0-1, the 2026 AHA/ASA guideline recommends EVT within 6 hours and from 6-24 hours when the other eligibility criteria are met. | This is the least extensive end of the ASPECTS early-ischemic-change scale. Higher baseline scores were associated with better functional outcome and lower symptomatic hemorrhage risk in the original thrombolysis cohort, but the score is not an individual prognosis. | Barber et al., Lancet 2000, Methods pp 1671-1672 and Fig 1; AHA/ASA 2026 AIS Guideline section 4.7.2, recommendations 1-2. | ✓ |
| >=6 | Scores 6-9, limited regional early ischemic change | Legacy RadCommons interpretation band for exact scores 6-9 because exact score 10 is represented separately. Each lost point denotes early ischemic change in one of the ten MCA regions; report the exact numeric score and involved regions rather than the band alone. | ASPECTS at least 6 is only one EVT input. For ICA or M1 occlusion with NIHSS at least 6 and prestroke mRS 0-1, EVT is recommended within 6 hours and from 6-24 hours under the 2026 AHA/ASA guideline; vessel, time, function, examination, and other imaging criteria must also be checked. | Scores 6-9 indicate less extensive regional early ischemic change than scores 0-5. Higher ASPECTS is generally associated with more favorable outcomes, but no score supplies a standalone probability or treatment result. | Barber et al., Lancet 2000, Methods pp 1671-1672 and Results/Discussion pp 1672-1673; AHA/ASA 2026 AIS Guideline section 4.7.2, recommendations 1-2. | ✓ |
| <6 | Scores 0-5, larger early ischemic change burden | Exact ASPECTS 0-5, indicating early ischemic change in at least five of the ten assessed MCA regions. This combined legacy band must be split into scores 3-5 versus 0-2 before applying current endovascular-treatment guidance. | Do not use ASPECTS below 6 as an automatic thrombectomy exclusion. In otherwise eligible ICA/M1 occlusion, EVT is recommended for ASPECTS 3-5 within 6 hours; from 6-24 hours it is recommended in selected patients younger than 80 with NIHSS at least 6, prestroke mRS 0-1, and no significant mass effect. For selected ASPECTS 0-2 patients younger than 80 with the same core clinical criteria and no significant mass effect, EVT within 6 hours is reasonable. | Lower ASPECTS reflects more extensive early ischemic change and was associated with worse functional outcome and greater symptomatic hemorrhage risk in the original cohort. It is not synonymous with wholly irreversible tissue and is not a standalone futility rule. | Barber et al., Lancet 2000, Methods pp 1671-1672 and Discussion p 1673; AHA/ASA 2026 AIS Guideline section 4.7.2, recommendations 1, 3, and 4. | ✓ |

### Citações por categoria
- **10**: Prabhakaran S, Gonzalez NR, Zachrison KS, et al.. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke (2026) — https://doi.org/10.1161/STR.0000000000000513 · Barber et al., Lancet 2000, Methods pp 1671-1672 and Fig 1; AHA/ASA 2026 AIS Guideline section 4.7.2, recommendations 1-2.
- **>=6**: Prabhakaran S, Gonzalez NR, Zachrison KS, et al.. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke (2026) — https://doi.org/10.1161/STR.0000000000000513 · Barber et al., Lancet 2000, Methods pp 1671-1672 and Results/Discussion pp 1672-1673; AHA/ASA 2026 AIS Guideline section 4.7.2, recommendations 1-2.
- **<6**: Prabhakaran S, Gonzalez NR, Zachrison KS, et al.. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke (2026) — https://doi.org/10.1161/STR.0000000000000513 · Barber et al., Lancet 2000, Methods pp 1671-1672 and Discussion p 1673; AHA/ASA 2026 AIS Guideline section 4.7.2, recommendations 1, 3, and 4.

## Histórico de versões

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


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> Conteúdo de referência reescrito. Confira a publicação primária vigente. Não é dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

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