# IVH Score

This score is used for patients with intracerebral hemorrhages with intraventricular extension, and is not appropriate for pure intraventricular hemorrhages. In this score, each lateral ventricle is graded as:

• 0 = no blood or small amount of layering
• 1 = up to 1/3 filled with blood
• 2 = 1/3 to 2/3 filled with blood
• 3 = mostly or completely filled with blood

3rd and 4th ventricles receive a score of:

• 0 = for no blood
• 1 = partially or completely filled with blood

Hydrocephalus was coded as

• 0 = absent
• 1 = present

The formula for calculating the IVH score is as follows: Or simplified:  3(RV+LV) + III + IV + 3(H)

Once the IVH score has been computed, the IVH volume can be calculated using the following formula: To make things simpler, here is a table showing the calculated IVH volume based on the IVH score.  Here are two examples of IVH scores calculated for you:  How to use the IVH Score?

With the IVH score, cutoff of 40 mL indicates poor outcome and 60 mL, mortality.

With the ICH score, cutoff is 25 mL and 30 mL respectively.

The total volume of hemorrhage can be calculated by adding the ICH volume (using the ABC/2 formula) and the IVH volume (using the ICH score).   Total volume predicts outcome better than ICH volume alone. NOTE:  Be wary of using ICH score and IVH score to withdraw care.  Early limitation of care in ICH / IVH is a self-fulfilling prophecy which is, of course, associated with mortality.

## Reference:

Hallevi, H., Dar, N., Barreto, A., Morales, M., Martin-Schild, S., Abraham, A., Walker, K., Gonzales, N., Illoh, K., Grotta, J. and Savitz, S. (2009). The IVH Score: A novel tool for estimating intraventricular hemorrhage volume: Clinical and research implications*. Critical Care Medicine, 37(3), pp.969-e1.