UMEM Educational Pearls

Category: Neurology

Title: What is the ICH Score?

Keywords: Guidelines, intracerebral hemorrhage, ICH score, communication (PubMed Search)

Posted: 6/10/2015 by WanTsu Wendy Chang, MD (Updated: 10/14/2015)
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What is the ICH Score?

The most recent AHA/ASA guideline for spontaneous intracerebral hemorrhage (ICH) recommends the use of a clinical severity score for communication.
While the NIHSS is used for ischemic stroke, its utility may be limited in ICH due to commonly depressed mental status.
The ICH Score is the most widely used and externally validated risk stratification scale:

An ICH Score calculator is available on MDCalc: (http://www.mdcalc.com/intracerebral-hemorrhage-ich-score/)

Take Home Point: Communicate the severity of your ICH patient by using either the composite ICH Score or by including details such as the patient's GCS, estimated volume of ICH, presence of IVH, and supra- vs. infratentorial origin.

References

1) Hemphill JC 3rd, Greenberg SM, Anderson CS, Becker K, Bendok BR, Cushman M, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015 May 28. [Epub ahead of print]

2) Hemphill JC 3rd, Bonovich DC, Besmertis L, Manley GT, Johnston SC. The ICH Score: A simple, reliable grading scale for intracerebral hemorrhage. Stroke. 2001;32(4):891-897.

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