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Scoring: Segmental estimation of the middle cerebral artery (MCA) vascular territory is made, and 1 point is deducted from the initial score of 10 for every region involved:
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Examples of each ASPECTS region. L indicates lentiform; I, insula; C, caudate; IC, internal capsule; M, MCA
Kuang, H., Najm, M., Chakraborty, D., Maraj, N., Sohn, S., & Goyal, M. et al. (2018). Automated ASPECTS on Noncontrast CT Scans in Patients with Acute Ischemic Stroke Using Machine Learning. American Journal Of Neuroradiology, 40(1), 33-38. doi: 10.3174/ajnr.a588
Scoring territories: Basically the higher the ASPECTs score the better the prognosis. High scores such as 10 are normal and low scores < 5 suggests evolved ischemic changes.
| Subcortical regions | Cortical regions |
|---|---|
| 1. Caudate | 5. M1: "anterior MCA cortex," corresponding to the frontal operculum |
| 2. Putamen | 6. M2: "MCA cortex lateral to insular ribbon" corresponding to the anterior temporal lobe |
| 3. Internal capsule | 7. M3: "posterior MCA cortex" corresponding to the posterior temporal lobe |
| 4. Insular cortex | 8. M4: "anterior MCA territory immediately superior to M1" |
| 9. M5: "lateral MCA territory immediately superior to M2" | |
| 10. M6: "posterior MCA territory immediately superior to M3” |
