ICH Score Calculator

Created by Dominika Śmiałek, MD, PhD candidate
Reviewed by Dominik Czernia, PhD and Jack Bowater
Last updated: Jan 04, 2023


Are you looking for a tool to assess the outcome of a patient after an intracerebral hemorrhage? This ICH score calculator determines ICH severity and the 30-day mortality after the incident. As a result, physicians, patients, and their families can decide on more adequate treatment protocols and goals. 📋

The article below shows some information on what the ICH medical abbreviation means, the brain hemorrhage survival rate, and an ICH score calculator practical example.

ICH medical abbreviation

ICH stands for intracerebral hemorrhage, a cerebral bleed that occurs either in brain tissue 🧠 or in ventricles (cavities between the tissue). In many cases, it occurs in both.

It's symptoms are often headache, vomiting, seizures, lowered level of consciousness, neck stiffness, and weakness in one sided.

Intracerebral hemorrhage causes

Now that you know what the medical abbreviation ICH means, let's move on to the origins of intracerebral hemorrhages and their risk factors. A variety of health conditions and situations may cause ICH:

  • Brain trauma, e.g., in a traffic accident;
  • Aneurysm rupture;
  • Arteriovenous malformations; and
  • Brain tumors.

People who take antithrombotic drugs, e.g., if they have atrial fibrillation ❤️, are at higher risk of bleeding. Therefore their one-year bleeding hazard needs to be estimated beforehand with the HAS-BLED calculator.

What are the other risk factors that raise the risk of intracerebral bleeding?

  • High blood pressure (estimate if it's correct with the MAP calculator);
  • Diabetes;
  • Amyloidosis;
  • Alcohol 🍷
  • Low cholesterol; and
  • Cocaine use.

👩‍⚕️👨‍⚕️ Physicians diagnose ICH based on a brain CT scan or an MRA (magnetic resonance angiography).

ICH score calculator

This tool estimates the mortality of the patient after suffering from an intracerebral hemorrhage using five factors. In other words, it determines the brain hemorrhage survival rate. In the brackets, you can see the number of points assigned to each category:

  1. Age, in years:
  • ≥ 80 years old (1)
  • < 80 years old (0)
  1. Glasgow Coma Scale (GCS), a neurological scale used to assess consciousness; the score is between 3 (deep unconsciousness) and 15 (normal, healthy status):
  • GCS < 5 (2)
  • 5 ≤ GCS < 13 (1)
  • 13 ≤ GCS (0)
  1. ICH volume , estimated from CT measurements (volume):
  • Volume ≥ 30 mL (1)
  • Volume < 30 mL (0)
  1. Whether the hemorrhage occurred inside the ventricles (intraventricular):
  • Yes (1)
  • No (0)
  1. If the hemorrhage's origin was infratentorial (origin):
  • Yes (1)
  • No (0)

The formula to calculate the ICH score is quite simple and is just the addition of the points from all five categories.

ICH = age + GCS + volume + intraventricular + origin

Brain hemorrhage survival rate in practice

The ICH score is a tool designed for medical practice and allows for fast segregation of patients based on their mortality risk due to an intracerebral hemorrhage. It improves the application of the physician's treatment protocols and of clinical research 🔬.

The interpretation of the score can be found in the table below:

ICH

Mortality rate

0

0%

1

13%

2

26%

3

72%

4

94%

5

100%

6

100%

*No patients in the study scored 6, but the estimated mortality is 100%

Let's imagine there's an 82-year-old patient with a diagnosis of an intracerebral hemorrhage that happened two hours ago. What is the treatment the physician can suggest? And what are the realistic goals for the survival of the patient during the next month?

Use this ICH score calculator:

  • Age: 82 y.o. (1)
  • GCS: 12 points (1)
  • ICH volume: 24 mL (0)
  • Bleeding inside the ventricles: Yes (1)
  • Infratentorial origin: No (0)

ICH score = 1 + 1 + 0 + 1 + 0

ICH score = 3 points

ICH score interpretation indicates that the patient's mortality risk for the following 30 days is 72%.

Dominika Śmiałek, MD, PhD candidate
Age
years
Glasgow Coma Scale
ICH volume
ml
Intraventricular hemorrhage
No
Infratentorial origin of hemorrhage
No
ICH Score
points
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