ICH Score Calculator — Intracerebral Hemorrhage
The ICH Score is a validated 6-point clinical grading scale that predicts 30-day mortality in patients with spontaneous intracerebral hemorrhage. Enter the five bedside variables to get an immediate risk estimate.
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mL
Intraventricular hemorrhage (IVH)
Infratentorial origin
Predicted 30-day mortality: 13%
- 1
GCS points
GCS 10 → 5–12 range = 1GCS 3–4 = 2 pts; GCS 5–12 = 1 pt; GCS 13–15 = 0 pts. - 2
Volume ≥ 30 mL
0< 30 mL on CT - 3
Intraventricular hemorrhage
0 - 4
Infratentorial origin
0 - 5
Age ≥ 80
0Patient age: 68 - 6
ICH Score total
1 + 0 + 0 + 0 + 0 = 1
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The ICH Score (0–6) predicts 30-day mortality from spontaneous intracerebral hemorrhage using five bedside variables: GCS (0–2 pts), CT volume ≥30 mL (1 pt), intraventricular blood (1 pt), infratentorial location (1 pt), and age ≥80 (1 pt). Mortality jumps from 0% at score 0 to ~100% at scores 5–6.
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How this is calculated
The ICH Score was developed by Hemphill et al. (2001, STROKE) as a simple bedside tool to stratify 30-day mortality risk in spontaneous intracerebral hemorrhage. Five variables are scored: the Glasgow Coma Scale (GCS 3–4 = 2 points; GCS 5–12 = 1 point; GCS 13–15 = 0 points), ICH volume on CT (≥30 mL = 1 point, estimated using the ABC/2 formula), presence of intraventricular hemorrhage (1 point), infratentorial origin — cerebellum or brainstem — (1 point), and patient age ≥80 years (1 point). The sum ranges from 0 to 6.
Mortality rises steeply with score: 0% at score 0, 13% at score 1, 26% at score 2, 72% at score 3, 97% at score 4, and essentially 100% at scores 5–6 in the original cohort. The score has been validated in multiple independent datasets and is widely used in neurocritical care and emergency medicine for goals-of-care discussions.
Important limitations: the ICH Score predicts short-term mortality, not functional outcome or long-term prognosis. Early withdrawal of care can become a self-fulfilling prophecy for high scores. The score does not account for anticoagulation reversal, surgical candidacy, or patient baseline function, all of which affect actual outcome. Use it as a communication aid, not as a threshold for treatment limitation.
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Volume is typically estimated from the CT scan using the ABC/2 formula: measure the largest diameter (A), the perpendicular diameter at the same slice (B), and the approximate number of CT slices times slice thickness (C), then compute A × B × C ÷ 2. This gives volume in mL.
Infratentorial refers to hemorrhages below the tentorium cerebelli — i.e., in the cerebellum or brainstem. These carry higher mortality than supratentorial (hemisphere) bleeds of the same volume, hence the separate score point.
The score is a prognostic guide for communication and triage, not a treatment algorithm. Even high-scoring patients may benefit from active intervention, especially if the score was obtained very early after onset or if potentially reversible causes (e.g., anticoagulant-related bleeding) are present.
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TG we-Calculate Editorial Team. (2026). ICH Score Calculator — Intracerebral Hemorrhage [Online calculator]. TG we-Calculate. https://we-calculate.com/ga/calculator/ich-calculator
TG we-Calculate Editorial Team. "ICH Score Calculator — Intracerebral Hemorrhage." TG we-Calculate. 2026. https://we-calculate.com/ga/calculator/ich-calculator.
TG we-Calculate Editorial Team, "ICH Score Calculator — Intracerebral Hemorrhage," TG we-Calculate, 2026. [Online]. Available: https://we-calculate.com/ga/calculator/ich-calculator
@misc{wecalculate_ich_calculator, title = {ICH Score Calculator — Intracerebral Hemorrhage}, author = {{TG we-Calculate Editorial Team}}, howpublished = {\url{https://we-calculate.com/ga/calculator/ich-calculator}}, year = {2026}, note = {TG we-Calculate} }
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