What GCS range defines each ICH score component?

A GCS of 3 to 4 scores 2 points. A GCS of 5 to 12 scores 1 point. A GCS of 13 to 15 scores 0 points.

What volume cut-off is used for the ICH volume component?

An ICH volume of 30 mL or greater scores 1 point; less than 30 mL scores 0. Volume is typically estimated from CT using the ABC/2 formula.

What are the 30-day mortality rates by ICH Score?

Score 0: ~0%, Score 1: ~13%, Score 2: ~26%, Score 3: ~72%, Score 4: ~97%, Score 5: ~100%, Score 6: ~100%. These rates come from the original Hemphill et al. 2001 validation cohort.

Does this tool replace clinical judgment?

No. The ICH Score is a prognostic aid, not a decision-making algorithm. Treatment decisions — including DNR status — must not be based on the score alone, as early withdrawal of care can artificially inflate observed mortality.

What does "infratentorial" mean?

Infratentorial refers to hemorrhages located below the tentorium cerebelli — specifically in the brainstem or cerebellum. Supratentorial hemorrhages (cerebral hemispheres, basal ganglia, thalamus) are not infratentorial.

How is ICH volume measured?

The standard method is ABC/2: A = longest diameter, B = perpendicular diameter, C = number of CT slices × slice thickness. This tool accepts the pre-calculated volume in milliliters.

ICH Score Calculator

Enter GCS, hemorrhage volume, IVH presence, origin, and age to calculate the ICH Score and estimated 30-day mortality risk.

Patient Parameters

Glasgow Coma Scale (GCS) at presentation

Total score 3–15. Lower = more impaired.

— pts

ICH Volume (mL, from CT ABC/2)

30 mL or more = 1 point.

— pts

Intraventricular Hemorrhage (IVH) present?

Yes (+1 pt) No (0 pts)

Infratentorial origin (brainstem or cerebellum)?

Yes (+1 pt) No (0 pts)

Patient Age (years)

Age 80 or older = 1 point.

— pts

ICH Score Result

out of 6

Estimated 30-Day Mortality

—

(Hemphill et al. 2001 cohort)

Component	Points
Total ICH Score

Fill in patient parameters and press
Calculate ICH Score.

Clinical disclaimer: The ICH Score is a prognostic aid for education and quality review. It must not be the sole basis for treatment decisions or withdrawal of care. Always apply clinical judgment and consult current guidelines.

Reference: Score vs. 30-Day Mortality

ICH Score	30-Day Mortality

Summary

The ICH Score is a validated clinical grading scale used in emergency and neurocritical care to estimate 30-day mortality in patients presenting with spontaneous intracerebral hemorrhage. It assigns points based on five independent predictors: Glasgow Coma Scale at presentation, hemorrhage volume on CT (using the ABC/2 method), presence of intraventricular hemorrhage, infratentorial (brainstem or cerebellar) origin, and patient age 80 or older. Scores range from 0 to 6, with higher scores corresponding to sharply higher mortality rates derived from the original validation cohort.

How it works

Enter the patient's Glasgow Coma Scale (GCS) score at presentation.
Enter the ICH volume in milliliters (calculated from CT using the ABC/2 formula).
Indicate whether intraventricular hemorrhage (IVH) is present.
Select whether the hemorrhage origin is infratentorial (brainstem or cerebellum).
Enter the patient's age.
The calculator totals the five component scores and displays the ICH Score with associated 30-day mortality rate.

Use cases

Rapid bedside prognostication for spontaneous intracerebral hemorrhage in the ED.
Guiding family conversations about goals of care in acute ICH.
Stratifying ICH patients by severity for clinical trials or audits.
Teaching medical students and residents the validated ICH scoring system.
Comparing predicted vs. observed mortality in quality-improvement reviews.
Triage decision support in neurocritical care unit admissions.

Frequently Asked Questions

Last updated: 2026-09-30 · Reviewed by Nham Vu

ICH Score Calculator

Use the ICH Score Calculator

Patient Parameters

ICH Score Result

Reference: Score vs. 30-Day Mortality

Summary

How it works

Use cases

Frequently Asked Questions