Which statement best describes the ASPECTS score in acute ischemic stroke?

Which statement best describes the ASPECTS score in acute ischemic stroke?

• A. A 5-point CT scoring system for early ischemic changes, where higher scores indicate larger infarcts
• B. A 10-point CT scoring system for early ischemic changes; lower scores imply larger infarcts and can influence thrombectomy eligibility and prognosis
• C. A 12-point CT scoring for perfusion deficits
• D. A 3-point CT score for hemorrhagic risk

Answer: (B)

The ASPECTS score is a 10-point CT-based assessment of early ischemic changes within the middle cerebral artery territory on non-contrast imaging. Each of 10 regions can receive 1 point if no early ischemic change is seen; points are subtracted for early signs in a region, so a normal scan scores a 10 and a lower score reflects a larger infarct core. This scoring helps estimate infarct size and, importantly, informs treatment decisions and prognosis because patients with higher scores (smaller infarcts) are more likely to benefit from reperfusion therapies like thrombectomy, while very low scores indicate extensive ischemia and a poorer prognosis. The statement in question correctly describes this 10-point system, the implication that lower scores mean larger infarcts, and its relevance to thrombectomy eligibility and prognosis. Other descriptions either misstate the score range, the imaging modality or what is being scored (perfusion deficits vs early ischemic changes) or refer to hemorrhagic risk, which are not what ASPECTS measures.

The ASPECTS score is a 10-point CT-based assessment of early ischemic changes within the middle cerebral artery territory on non-contrast imaging. Each of 10 regions can receive 1 point if no early ischemic change is seen; points are subtracted for early signs in a region, so a normal scan scores a 10 and a lower score reflects a larger infarct core. This scoring helps estimate infarct size and, importantly, informs treatment decisions and prognosis because patients with higher scores (smaller infarcts) are more likely to benefit from reperfusion therapies like thrombectomy, while very low scores indicate extensive ischemia and a poorer prognosis. The statement in question correctly describes this 10-point system, the implication that lower scores mean larger infarcts, and its relevance to thrombectomy eligibility and prognosis. Other descriptions either misstate the score range, the imaging modality or what is being scored (perfusion deficits vs early ischemic changes) or refer to hemorrhagic risk, which are not what ASPECTS measures.