Baseline ASPECTS predicts early neurological deterioration and functional outcomes after endovascular thrombectomy in acute ischemic stroke

END after EVT independently predicts poor 90-day functional independence (mRS 0-2) in LVO-related AIS. Our findings support incorporating a baseline ASPECTS ≤7 into risk stratification protocols to identify high-risk patients requiring intensive neuromonitoring (hourly NIHSS assessments for 72 h post-EVT). Early detection of END signs, such as a ≥ 4-point increase in the NIHSS score 4, may enable prompt interventions (e.g., blood pressure control or edema management) to improve long-term outcomes.