Free ICH Score Calculator

Understanding the ICH Score and Its Role in Brain Hemorrhage Prognosis

The Intracerebral Hemorrhage (ICH) score is a clinical grading scale that helps healthcare providers assess the severity of bleeding within the brain tissue and estimate the likelihood of survival over the next 30 days. Developed in 2001 by Hemphill and colleagues, this scoring system integrates five key factors to produce a single number that correlates with mortality risk. This article explains the meaning of ICH, details the components of the score, and provides a step-by-step example of how the ICH mortality calculator works.

Important: This calculator is designed for educational and informational purposes only. It should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified physician regarding your specific health situation.

What Is Intracerebral Hemorrhage (ICH)?

ICH refers to a type of stroke caused by bleeding directly into the brain parenchyma or into the ventricles (fluid‑filled spaces within the brain). In many cases, both sites are involved. Common symptoms include sudden headache, vomiting, seizures, reduced consciousness, neck stiffness, and unilateral weakness. The condition is often life‑threatening and requires immediate medical attention.

Risk Factors and Causes

Several conditions can lead to an intracerebral hemorrhage:

• Traumatic brain injury (e.g., from accidents)
• Ruptured aneurysms
• Arteriovenous malformations
• Brain tumors

Patients taking antithrombotic medications (for example, those with atrial fibrillation) face an elevated bleeding risk. Physicians frequently use the HAS‑BLED score to estimate that risk. Other contributing factors include:

• Chronic hypertension (high blood pressure)
• Diabetes mellitus
• Amyloidosis
• Excessive alcohol consumption
• Low cholesterol levels
• Cocaine use

Diagnosis is typically confirmed through a brain CT scan or magnetic resonance angiography (MRA).

Components of the ICH Grading Scale

The ICH grading scale assigns points based on five clinical and radiographic parameters. The total score ranges from 0 to 6, with higher scores indicating greater severity and lower brain hemorrhage survival rate.

Parameter	Criteria	Points
Age	≥ 80 years	1
	< 80 years	0
Glasgow Coma Scale (GCS)	GCS < 5	2
	5 ≤ GCS < 13	1
	GCS ≥ 13	0
ICH Volume (measured on CT)	≥ 30 mL	1
	< 30 mL	0
Intraventricular hemorrhage	Present	1
	Absent	0
Infratentorial origin	Present	1
	Absent	0

The overall ICH score is the sum of the points from all five categories:

$$\text{ICH} = \text{Age} + \text{GCS} + \text{Volume} + \text{Intraventricular} + \text{Origin}$$

Interpreting the Score: 30‑Day Mortality

The original study by Hemphill et al. established a clear correlation between the ICH score and mortality within 30 days. The following table summarizes the findings:

ICH Score	30‑Day Mortality
0	0%
1	13%
2	26%
3	72%
4	94%
5	100%
6	100% (estimated)

No patients in the original cohort scored 6, but the predicted mortality is considered 100%.

Practical Example Using the ICH Mortality Calculator

Consider a 82‑year‑old patient diagnosed with an intracerebral hemorrhage. The clinical assessment yields the following data:

• Age: 82 years → 1 point
• GCS: 12 → 1 point
• ICH volume on CT: 24 mL → 0 points
• Intraventricular extension: present → 1 point
• Infratentorial origin: absent → 0 points

$$\text{ICH} = 1 + 1 + 0 + 1 + 0 = 3$$

According to the table, an ICH score of 3 corresponds to a 72% mortality risk within the next 30 days. This information helps guide treatment discussions and realistic goal setting for the patient and family.

Summary

The ICH score remains a simple yet powerful tool for quantifying intracerebral hemorrhage severity and predicting short‑term survival. By combining age, neurological status, hematoma volume, and hemorrhage location, the ICH grading scale provides clinicians and families with valuable prognostic information. Use the free online ICH score calculator to quickly compute the score and interpret the corresponding mortality risk.