Modified Pediatric ASPECTS: Building Tools for Future Pediatric Stroke Studies

The Alberta Stroke Program Early CT Score (ASPECTS) is a quick and reliable semiquantitative tool to estimate the size of an acute ischemic infarct on a noncontrast head CT.1 Ten brain regions in the middle cerebral artery territory are evaluated, with 1 point subtracted for each infarcted region; total scores range from 0 to 10. Lower ASPECTS, indicating larger infarct burden, has been associated with higher risk of hemorrhagic transformation and worse outcomes in adult patients with stroke2 and is one criterion considered in the assessment of eligibility for thrombectomy. A version of this scoring system, the modified pediatric ASPECTS (modASPECTS), was developed to measure infarct size in children using diffusion-weighted sequences on MRI.3 For modASPECTS, 30 regions are scored, including areas of the anterior and posterior cerebral artery territories in addition to the middle cerebral artery territory.4 One point is added for each area involved, resulting in a score from 0 to 30, with higher scores indicating more areas of infarct.

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