An ASPECTS score of 6 or higher indicates what?

• A. Small to moderate ischemic core; patient would benefit from mechanical thrombectomy
• B. Extant infarct; thrombectomy contraindicated
• C. No ischemia; thrombolysis only
• D. Severe edema; urgent decompression

Answer: (A)

ASPECTS is a 10-point CT scoring system that measures early ischemic changes in the middle cerebral artery territory. Each of 10 regions is scored as normal (no early changes) or shows early ischemia (subtract one). A higher score means less damaged tissue and more salvageable brain (smaller ischemic core). In patients with anterior circulation large-vessel occlusion, having a score of 6 or higher indicates a relatively small to moderate core with substantial penumbra, making rapid revascularization with mechanical thrombectomy beneficial and guideline-supported. This is why the statement that a 6 or higher reflects a small to moderate core and supports thrombectomy is the best choice. Lower scores suggest a larger infarct where benefits are reduced and management may differ; the other options do not align with what a higher ASPECTS signifies.