Two axial slides are evaluated (one at basal ganglia level, one at the top of the lateral ventricles). 1 point is allotted for normal density in each region shown (insular cortex, M1 through M6, caudate, lentiform nucleus, internal capsule). A normal study is given 10 points.
Figure adapted from Barber et al
A normal head CT at the time of presentation is associated with better outcomes if recanalization is achieved. Hypodensity or loss of the gray/white interface is associated with worse outcomes. The ASPECTS score is a simple and reproducible method assessing hypodensity on CT during acute ischemic stroke. It can be used to predict functional outcome and symptomatic hemorrhage with high sensitivity and specificity.