A 60-year-old man with known atrial fibrillation presents with sudden left hemiplegia 1.5 hours after onset. Non-contrast CT brain is performed. An ASPECTS score is calculated by evaluating 10 regions of the MCA territory. Which two regions form the subcortical component of the ASPECTS scoring?
- A Caudate nucleus and lentiform nucleus ✓
- B Caudate nucleus and posterior limb of the internal capsule
- C Putamen and caudate nucleus
- D Internal capsule and lentiform nucleus
Explanation
The Alberta Stroke Program Early CT Score (ASPECTS) assesses 10 defined MCA territory regions on non-contrast CT to quantify early ischaemic change. Each region present and normal scores 1 point, with each detected abnormality subtracting one point from 10. The two subcortical deep regions are the caudate nucleus and lentiform nucleus (putamen and globus pallidus together). The remaining 8 regions are cortical: insula, M1 through M6. A score of 10 indicates no detectable ischaemia; a score below 7 is associated with poor functional outcome and increased haemorrhagic transformation risk after thrombolysis.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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