What is ASPECTS (Early CT Stroke Score)?

Quantify early MCA ischaemic change on non-contrast CT with ASPECTS (10 regions, score 0–10).

How is ASPECTS (Early CT Stroke Score) calculated? What is the core formula?

Start at 10; subtract 1 for each of C, L, IC, I, M1–M6 with early ischaemic change. Score each region for hypodensity/effacement consistent with acute ischaemia; exclude chronic change when possible.

What are the key clinical points for ASPECTS (Early CT Stroke Score)?

10 MCA regions. Pair with NIHSS and vascular imaging. Next: local stroke code / reperfusion checklist.

What are the limits and cautions when using ASPECTS (Early CT Stroke Score)?

When not to use: posterior-circulation-only syndromes (use pc-ASPECTS variants if locally adopted), non-MCA territory decisions alone. Pitfall: scoring chronic infarcts as acute early change. ASPECTS alone must not approve or deny thrombolysis/EVT. For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.

Does ASPECTS (Early CT Stroke Score) upload patient data? Where is it calculated?

Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.

How is ASPECTS (Early CT Stroke Score) calculated in practice? Can you show a worked example?

Inputs: Caudate (C) early change No (keep point), Lentiform (L) early change No (keep point), Internal capsule (IC) early change No (keep point), Insular ribbon (I) early change No (keep point), M1 (anterior MCA cortex) early change No (keep point), M2 (MCA cortex lateral to insular ribbon) early change No (keep point), M3 (posterior MCA cortex) early change No (keep point), M4 (anterior MCA superior) early change No (keep point)… → Result: ASPECTS 10 /10（Regions with early change: 0, Bands (contextual): Higher score — less early MCA change） Inputs: Caudate (C) early change Yes (−1), Lentiform (L) early change Yes (−1), Internal capsule (IC) early change Yes (−1), Insular ribbon (I) early change Yes (−1), M1 (anterior MCA cortex) early change Yes (−1), M2 (MCA cortex lateral to insular ribbon) early change Yes (−1), M3 (posterior MCA cortex) early change Yes (−1), M4 (anterior MCA superior) early change Yes (−1)… → Result: ASPECTS 0 /10（Regions with early change: 10, Bands (contextual): Extensive early MCA change）

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🧠 ASPECTS (Early CT Stroke Score)

UseWhen to use: suspected acute anterior-circulation ischaemic stroke staging on NCCT.

Loading calculator…

StrataHigher scores = less early injury; thresholds for reperfusion are pathway-specific and must include NIHSS, ti…

LimitsWhen not to use: posterior-circulation-only syndromes (use pc-ASPECTS… · Pitfall: scoring chronic infarcts as acute early change. · ASPECTS alone must not approve or deny thrombolysis/EVT.

SourceAHA/ASA AIS early management; 《中国急性缺血性脑卒中诊治指南2023》 on zh pages

Runs locally in your browser (no PHI uploaded). For licensed clinicians — not a substitute for clinical judgement.

Stored on this device for revisit reminders

This-shift next steps

After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.

Scene next step

📋Stroke codeOpen scene pack →

Related scores

Matching pathway

🧭strokeOpen pathway →

Score + version; reference only — not a substitute for care · no HIS write

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Methodology · worked example, guidelines & full notes

Clinical takeaway

10 MCA regions.

When to use

When to use: suspected acute anterior-circulation ischaemic stroke staging on NCCT.

How it works

Start at 10; subtract 1 for each of C, L, IC, I, M1–M6 with early ischaemic change.

Key points

10 MCA regions.
Pair with NIHSS and vascular imaging.
Next: local stroke code / reperfusion checklist.

References

[Guideline / primary source]AHA/ASA AIS early management; 《中国急性缺血性脑卒中诊治指南2023》 on zh pages
Barber PA, et al. Lancet 2000 (ASPECTS)

Worked calculation

The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.

Caudate (C) early change	No (keep point)
Lentiform (L) early change	No (keep point)
Internal capsule (IC) early change	No (keep point)
Insular ribbon (I) early change	No (keep point)
M1 (anterior MCA cortex) early change	No (keep point)
M2 (MCA cortex lateral to insular ribbon) early change	No (keep point)
M3 (posterior MCA cortex) early change	No (keep point)
M4 (anterior MCA superior) early change	No (keep point)
M5 (lateral MCA superior) early change	No (keep point)
M6 (posterior MCA superior) early change	No (keep point)

→ASPECTS10/10

Regions with early change：0
Bands (contextual)：Higher score — less early MCA change

Caudate (C) early change	Yes (−1)
Lentiform (L) early change	Yes (−1)
Internal capsule (IC) early change	Yes (−1)
Insular ribbon (I) early change	Yes (−1)
M1 (anterior MCA cortex) early change	Yes (−1)
M2 (MCA cortex lateral to insular ribbon) early change	Yes (−1)
M3 (posterior MCA cortex) early change	Yes (−1)
M4 (anterior MCA superior) early change	Yes (−1)
M5 (lateral MCA superior) early change	Yes (−1)
M6 (posterior MCA superior) early change	Yes (−1)

→ASPECTS0/10

Regions with early change：10
Bands (contextual)：Extensive early MCA change

Verification & sources · governance

FAQ

Frequently asked questions

Does ASPECTS (Early CT Stroke Score) upload patient data? Where is it calculated?: Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
How is ASPECTS (Early CT Stroke Score) calculated in practice? Can you show a worked example?: Inputs: Caudate (C) early change No (keep point), Lentiform (L) early change No (keep point), Internal capsule (IC) early change No (keep point), Insular ribbon (I) early change No (keep point), M1 (anterior MCA cortex) early change No (keep point), M2 (MCA cortex lateral to insular ribbon) early change No (keep point), M3 (posterior MCA cortex) early change No (keep point), M4 (anterior MCA superior) early change No (keep point)… → Result: ASPECTS 10 /10（Regions with early change: 0, Bands (contextual): Higher score — less early MCA change） Inputs: Caudate (C) early change Yes (−1), Lentiform (L) early change Yes (−1), Internal capsule (IC) early change Yes (−1), Insular ribbon (I) early change Yes (−1), M1 (anterior MCA cortex) early change Yes (−1), M2 (MCA cortex lateral to insular ribbon) early change Yes (−1), M3 (posterior MCA cortex) early change Yes (−1), M4 (anterior MCA superior) early change Yes (−1)… → Result: ASPECTS 0 /10（Regions with early change: 10, Bands (contextual): Extensive early MCA change）

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