ASPECTS — Alberta Stroke Program Early CT Score
10-point CT scoring system for early ischaemic changes in the MCA territory. Lower score = more ischaemic damage. ASPECTS ≤7 associated with poor thrombolysis outcome.
Score interpretation
ASPECTS 8–10 — minimal early ischaemic changes. Good prognosis.
→ Eligible for thrombolysis and thrombectomy; good chance of functional independence
ASPECTS 5–7 — moderate early ischaemic changes. Increased risk of haemorrhagic transformation.
→ Thrombectomy may still be beneficial (discuss at neuro-IR MDT); thrombolysis risk/benefit discussion; ASPECTS ≤7 predicts poor outcome post-thrombolysis
ASPECTS 0–4 — extensive early ischaemic changes. High risk of poor outcome.
→ Consider palliative care discussion; thrombolysis generally not recommended; thrombectomy unlikely to benefit; decompressive craniectomy discussion
Interpretation bands for the ASPECTS. Apply clinical judgement and local guidance.
References
- Barber PA et al. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. Lancet. 2000;355(9216):1670–1674.
Related
Curated clinical cross-links plus same-class fallbacks.
- Aspirin (Loading Dose) · Antiplatelet — ACS / Ischaemic Stroke
- Alteplase (tPA) · Thrombolytic — Ischaemic Stroke / Massive PE
- Tenecteplase (Stroke) · Stroke Thrombolysis
- Alteplase (STEMI Thrombolysis) · Thrombolytic / STEMI
- Streptokinase (STEMI Thrombolysis) · Thrombolytic / STEMI
- Cetuximab · Anti-EGFR Monoclonal Antibody — Head and Neck Cancer
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.