Baseline ASPECT Scores predict extent of stroke: Interim CT Analysis of CASES
Background CT scanning remains the fastest and easiest method of neuro-imaging in acute ischemic stroke. The ASPECT score has been shown to be useful in assessing acute CT scans and has demonstrated validity and reliability. Previous studies have not prospectively evaluated early CT ischemia using ASPECTS. Methods 115 CT scans from the CASES study have been reviewed to date. All baseline and 24–48h follow-up scans were examined by a panel of 3 reviewers. Rating was done by 1 neuroradiologist and 2 of 3 neurologists per session. Consensus was achieved by majority opinion (2 of 3) on each data point. Reviewers were aware of the symptom side but blind to other patient characteristics. Results 79% of CT scans showed some degree of early ischemic change (ASPECTS < 10). 4.3% of follow up scans were normal (ASPECTS=10) when the baseline ASPECT score was < 9. The baseline ASPECT score was highly associated with the follow-up score (p<0.001) (Figure) Discussion Early ischemic change is common on baseline CT scans. A minority of CT scans may be over-interpreted using ASPECTS. Baseline ASPECT score predicts the regions of infarction in follow-up.