Fifteen radiologists independently evaluated fifty non-contrast brain computed tomography of patients with middle cerebral artery (MCA) stroke. Within-group agreement was either negligible or moderate, and the best inter-expert agreement was observed between neuroradiologists with 1 to 3 years of experience. Our study allows us to conclude that ASPECTS is not an ideal tool for standardizing the diagnosis of MCA stroke, therefore, it is necessary to develop new models of standardization systems, as well as the use of hydride diagnostics, including automatic analysis.