International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 4, Issue 1 | Review Article | Open Access
Lamia Bencherif*
Lamia Bencherif1, Elisabeth Confais2, Gregory Couvreur3, Elena Messeguer4 Saint Brieuc Hospital Center, Neurology Department Center of Cerebrovascular Accident, Bichat-Claude-Bernard Hospital, Paris France
*Correspondence to: Lamia Bencherif
Fulltext PDFThe Alberta Stroke Program Early Computed Tomography Score (ASPECTS), initially developed for computed tomography (CT) imaging, is a quantitative radiological score that provides a simple and reproducible method for assessing early signs of cerebral ischemia. These signs include effacement of the lenticular nucleus, insular ribbon, and cortical sulci, as well as discrete hypodensity in the cerebral parenchyma within the middle cerebral artery (MCA). This score is derived from two standard axial scans or magnetic resonance site plans: the first includes the thalamus and lenticular nuclei, and the second includes the lateral ventricles.
Between these two plans, the MCA was divided into ten areas of interest, each assigned one point. Three points were allocated for subcortical structures, and seven points were allocated to cortical structures. One point was subtracted for each region that showed early ischemic changes. Thus, an ASPECTS of 10 indicated a normal scan, whereas a 0 indicated diffuse ischemia throughout the extended or malignant MCA area.
Previous studies have demonstrated that diffusion-weighted imaging–ASPECTS is superior to CT-ASPECTS for detecting early signs of ischemia and in terms of inter-reader reproducibility. This score has been used in several studies to evaluate the functional prognosis and risk of symptomatic hemorrhagic transformation (HT) after a recanalization procedure, either by intravenous thrombolysis or thrombectomy. Radio-clinical criteria such as age, cardiovascular risk factors, blood pressure and blood glucose levels on admission, history of ischemic stroke and atrial fibrillation, use of antithrombotic agents, presence or absence of collateral circulation, microbleeds, slow flow, and leukoaraiosis also influence functional prognosis and the risk of HT.
The therapeutic approach, along with the time between symptom onset and recanalization, affects the functional prognosis and risk of HT. The recurrent question that neurovascular clinicians, regardless of experience, encounter when managing a patient in a fibrinolysis alert is: which reliable tools and
Lamia Bencherif, Elisabeth Confais, Gregory Couvreur, Elena Messeguer. Predicting The Risk of Symptomatic Intracerebral Hemorrhagic Transformation in Acute Ischemic Stroke Using Dwi-Aspect and Literature Review. Int Clinc Med Case Rep Jour. 2024;4(1):1-36.