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Neuroradiology & Spine

Stroke, vascular, skull base and spinal classification tools.

ASPECTS - Alberta Stroke Program Early CT Score
ASPECTS (Barber et al., 2000)

Scores early ischemic change in the ten MCA-territory regions on non-contrast CT; the score is 10 minus the number of abnormal regions.

Carotid Stenosis (NASCET & ECST)
NASCET (1991) / ECST (1998) diameter methods

Computes percent ICA stenosis by the NASCET method (residual lumen vs normal distal ICA) and the ECST method (residual lumen vs estimated bulb diameter).

Intracerebral Hemorrhage Volume (ABC/2)
ABC/2 (Kothari et al., 1996)

Estimates parenchymal hematoma volume on CT with the ABC/2 method (ellipsoid hematomas) or ABC/3 variant (irregular, separated, or multinodular hematomas).

AO Spine Thoracolumbar Injury Classification
AOSpine Thoracolumbar Classification (2013) + TL AOSIS (2016)

Classifies thoracolumbar spine injuries into morphology types A0–A4, B1–B3 and C together with neurologic status (N0–N4/NX) and the M1/M2 modifiers, and derives the Thoracolumbar AOSpine Injury Score (TL AOSIS) that feeds the published surgical algorithm.

Knosp Classification (Pituitary Adenoma)
Revised Knosp (Knosp 1993; Micko 2015 modification)

Grades parasellar extension of a pituitary adenoma on coronal MRI from its relationship to the medial tangent, intercarotid line, and lateral tangent of the cavernous carotid artery, using the revised 0–4 scale with the 3A/3B subdivision.

NI-RADS (Head & Neck Surveillance)
ACR NI-RADS (2018 white paper)

ACR NI-RADS risk-stratifies post-treatment head and neck surveillance imaging: the primary site and the neck nodes are each categorized 0–4 for suspicion of recurrence, with linked management from routine surveillance to biopsy or treatment.

SINS (Spinal Instability Neoplastic Score)
SINS (SOSG, Fisher/Bilsky 2010)

Sums six clinical and imaging components — location, mechanical pain, bone lesion quality, alignment, vertebral body collapse, and posterolateral element involvement — into the 0–18 Spinal Instability Neoplastic Score, banded stable / indeterminate / unstable.

Posterior Circulation ASPECTS (pc-ASPECTS)
pc-ASPECTS (Puetz 2008)

A 10-point CT scoring system for early ischemic change in the posterior circulation. Points are deducted for hypoattenuation in the thalami, cerebellum and occipital lobes (1 each side) and in the midbrain and pons (2 each); 10 means no visible ischemia.

Fisher & Modified Fisher Grade (SAH)
Fisher (1980) + modified Fisher (Frontera 2006)

Grades the CT blood burden after aneurysmal subarachnoid hemorrhage to estimate vasospasm risk. Both the original Fisher scale (1–4) and the modified Fisher scale of Frontera (0–4) are reported side by side because the two are frequently confused.

Hunt & Hess Grade
Hunt & Hess (1968)

Clinical severity grading (I–V) of subarachnoid hemorrhage based on headache, meningismus, level of consciousness and focal deficit. Higher grades predict higher mortality and perioperative risk.

PHASES Aneurysm Rupture Risk
PHASES (Greving 2014)

Estimates the absolute 5-year rupture risk of an incidental intracranial saccular aneurysm from six factors — Population, Hypertension, Age, Size, Earlier SAH and Site — and maps the 0–22 point total to the published risk lookup.

TLICS — Thoracolumbar Injury Classification & Severity Score
TLICS (Vaccaro 2005)

Scores thoracolumbar fractures from injury morphology (1–4), posterior ligamentous complex integrity (0–3) and neurologic status (0–3). Totals guide management: ≤ 3 nonoperative, 4 indeterminate, ≥ 5 surgical.

SLICS — Subaxial Injury Classification & Severity Score
SLICS (Vaccaro 2007)

Scores subaxial (C3–C7) cervical injuries from morphology (0–4), discoligamentous complex integrity (0–2) and neurologic status (0–3, +1 for persistent cord compression with deficit). Totals: ≤ 3 nonoperative, 4 indeterminate, ≥ 5 surgical.

Fazekas Scale (White Matter Lesions)
Fazekas (1987)

The standard visual rating of white matter hyperintensities on T2/FLAIR. Periventricular and deep white matter are each graded 0–3; both subscales and their descriptive sum are reported.

Medial Temporal Atrophy (Scheltens MTA)
Scheltens MTA (1992)

Visual rating of medial temporal (hippocampal) atrophy, 0–4 per side, on coronal images. Age-adjusted interpretation: a grade of 2 or more is abnormal under age 75, and 3 or more is abnormal at 75 and older.

Global Cortical Atrophy (Pasquier GCA)
Pasquier GCA (1996, simplified single grade)

A single global visual grade (0–3) of cortical atrophy on CT or MRI, integrating sulcal widening, gyral volume loss and ventricular enlargement: 0 none, 1 mild, 2 moderate, 3 severe ("knife blade").

mTICI / TICI Reperfusion Grade
1.0.0

Assigns the modified Treatment in Cerebral Infarction (mTICI) grade after endovascular thrombectomy, including the commonly used 2c subcategory. Reports whether reperfusion meets the conventional “successful” threshold (mTICI ≥2b) and the preferred near-complete/complete target (≥2c/3).

WFNS Grading Scale (SAH)
1.0.0

Derives the World Federation of Neurosurgical Societies (WFNS) clinical grade I–V for aneurysmal subarachnoid hemorrhage from Glasgow Coma Scale band and presence or absence of a major focal neurological (motor) deficit.

ABCD2 Score (TIA Stroke Risk)
1.0.0

Calculates the ABCD2 score (0–7) after suspected TIA from age, blood pressure, clinical features, symptom duration, and diabetes, and reports the classic 2-day, 7-day, and 90-day stroke-risk tiers from the validation cohorts.

Spetzler-Martin AVM Grade
1.0.0

Computes the Spetzler-Martin grade (I–V) for brain arteriovenous malformations from nidus size, eloquence of adjacent brain, and pattern of venous drainage, and maps the sum to a surgical-risk tier.

Koos Classification (Vestibular Schwannoma)
1.0.0

Assigns Koos grade I–IV for vestibular schwannoma based on intracanalicular versus cisternal extent and contact or compression of the brainstem, aiding surgical and radiosurgical planning.

ARWMC Scale (Wahlund White Matter Changes)
1.0.0

Applies the Age-Related White Matter Changes (ARWMC) scale of Wahlund et al. (2001): five regions rated 0–3 in each hemisphere on CT or MRI, summed to a total burden score (0–30) with a practical severity tier.

ICH Score
ICH Score (Hemphill 2001)

Predicts 30-day mortality after spontaneous intracerebral hemorrhage from GCS, ICH volume, intraventricular extension, infratentorial origin, and age. Total score 0–6.

Evans' Index
Evans' Index (Evans 1942)

Ratio of the maximum width of the frontal horns of the lateral ventricles to the maximum internal skull diameter on the same axial slice. A ratio of 0.3 or more suggests ventriculomegaly.

RoPE Score (PFO in Cryptogenic Stroke)
RoPE score (Kent et al., Neurology 2013)

Scores six items — age band, absence of hypertension, diabetes, prior stroke/TIA and smoking, plus a cortical infarct on imaging — to estimate how likely a patent foramen ovale found after cryptogenic stroke is the cause rather than an incidental finding. Total 0–10, with the stratum-specific attributable fraction and 2-year recurrence estimates from the derivation cohort.