ICH Score Calculator (Intracerebral Hemorrhage)
Calculate the ICH score for spontaneous intracerebral hemorrhage — Glasgow Coma Scale, hematoma volume (ABC/2), intraventricular blood, infratentorial origin and age — score 0–6 with 30-day mortality.
How it works
GCS 3–4 = 2, 5–12 = 1, 13–15 = 0; ICH volume ≥ 30 mL = 1; intraventricular hemorrhage = 1; infratentorial origin = 1; age ≥ 80 = 1. Total 0–6. 30-day mortality: 0 → 0%, 1 → 13%, 2 → 26%, 3 → 72%, 4 → 97%, 5 → 100% (no patient scored 6; estimated 100%).
The ICH score (Hemphill et al., Stroke 2001) is a simple grading scale for spontaneous intracerebral hemorrhage built from features available on arrival. It is meant for communication and research stratification, not as the sole basis for limiting care: early do-not-resuscitate orders themselves worsen outcomes, and the 2022 AHA/ASA guideline advises against using severity scores alone to decide on withdrawal of treatment.
Worked example
A 72-year-old with GCS 11 (1 point), a 35 mL hematoma (1), intraventricular extension (1), supratentorial location (0) and age under 80 (0) has an ICH score of 3 / 6, with 72% 30-day mortality in the original cohort.
Sources: Hemphill JC et al. — The ICH score (Stroke 2001) · Greenberg SM et al. — 2022 AHA/ASA Guideline for Spontaneous Intracerebral Hemorrhage
Frequently asked questions
How is hematoma volume measured with ABC/2?
On the CT slice with the largest bleed, A is the largest diameter and B the diameter at 90° to A (cm). C is the number of slices with blood multiplied by slice thickness (cm). Volume ≈ A × B × C / 2 in mL.
Does a high ICH score mean treatment is futile?
No. The original mortality figures partly reflect early withdrawal of care. Guidelines recommend full aggressive care initially and caution against using the score alone for prognosis.
Is the ICH score used for traumatic or subarachnoid bleeds?
No — it was developed for spontaneous (non-traumatic) intracerebral hemorrhage. Subarachnoid hemorrhage uses Hunt and Hess or WFNS grades.
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Clinical decision tool for education and for use by trained clinicians alongside clinical judgement — not a diagnosis and not a substitute for medical assessment. Formulas and cut-offs come from the cited sources; local protocols may differ.