Cho et al developed a modified intracerebral hemorrhage (MICH) score for patients with a hemorrhagic stroke involving the basal ganglia. This can help the clinician to make appropriate treatment decisions for the patient. The authors are from China Medical University Hospital in Taichung, Taiwan.
Parameters:
(1) Glasgow coma score (GCS)
(2) volume of the intracerebral hemorrhage in mL
(3) hydrocephalus or intraventricular hemorrhage
Parameter
Findings
Points
GCS score
13 to 15
0
5 to 12
1
3 or 4
2
ICH volume
<= 20 mL
0
21 to 50 mL
1
>= 51 mL
2
hydrocephalus or intraventricular hemorrhage
neither
0
either or both
1
modified intracerebral hemorrhage =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the more severe the disease.
• All patients with a score of 5 died.
• A patient with a score of 3 or 4 has a lower mortality with surgical management.
• A patient with a score of 2 should have surgical therapy since this has a better functional outcome.
• A patient with a score of 0 or 1 should have conservative therapy since this is associated with preservation of neurologic function.
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