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Keywords:

  • ASPECT;
  • computed tomography score;
  • diffusion weighted imaging;
  • imaging;
  • ischaemia;
  • stroke

There is mounting evidence that shows how poorly non-contrast computed tomography (NCCT) Alberta Stroke Program Early CT Score (ASPECTS) performs in the first three-hours after stroke onset compared to Diffusion weighted (DWI) magnetic resonance imaging (MRI). It is time to move into the 21st century and use more advanced imaging routinely in hyper-acute stroke assessment. While a useful tool if one is limited to NCCT alone, ASPECTS becomes somewhat superfluous as we now have rapid, validated, automated infarct core and penumbra volumes with either MRI or perfusion CT.