Middle cerebral artery territory in ASPECTS study


A. CT axial slice at the level of thalamus and basal ganglion (Includes 4 deep* and 3 cortical territories):

  • C - caudate head*
  • LN - lentiform nucleus*
  • IC - internal capsule*
  • I - insular cortex*
  • M1 - anterior MCA cortex
  • M2 - MCA cortex lateral to insular ribbon
  • M3 - posterior MCA cortex

("A" - anterior circulation, "P" - posterior circulation)

B. CT axial slice at the level adjacent to the most superior margin of the ganglionic structures (Includes 3 cortical territories):

  • M4, M5, M6 - anterior, lateral and posterior MCA territories, respectively (approximately 2cm superior to M1, M2 and M3 respectively)

Practical points:

  • total 10 MCA territory allotted where each area equals to 1 point 1
  • normal CT scan received an ASPECTS of 10 points 1
  • a score of <7 is equal to one-third of the MCA territory 1
  • a score of zero indicates diffuse ischemia involvement throughout the MCA territory 1