ICH Volume Calculator

Estimating intracerebral hemorrhage volume is a routine part of stroke and neurocritical care because clot size strongly influences severity, mass effect, and prognosis. In many acute settings, clinicians need a quick calculation before advanced software or formal volumetric segmentation is available. The ABC/2 method became popular because it can be performed rapidly on CT by measuring the largest hemorrhage diameter, a perpendicular width, and an approximate depth. Multiplying those values and dividing by two gives a fast bedside estimate that is often close enough to support triage and communication. The ellipsoid method uses a geometric formula that assumes the bleed resembles an ellipsoid. It is still an approximation, but it can be a useful comparison when the hemorrhage contour is smoother or when a team wants a slightly more formal geometric estimate. Neither method is perfect. Irregularly shaped bleeds, layered blood products, mixed-density lesions, or substantial intraventricular extension can all make simple three-diameter models less accurate. Even so, these quick formulas remain clinically helpful because they provide a shared language for describing size and for connecting that size to prognosis studies and scoring systems. This calculator labels the result as mild, moderate, large, or massive using a simple volume-based scale. Those labels are descriptive rather than diagnostic. A small brainstem hemorrhage can be far more dangerous than a larger lobar hemorrhage, and location, hydrocephalus, blood pressure, anticoagulation, and neurologic examination all matter. Volume is one dimension of severity, not the whole story. Small differences in how A, B, or C are measured can also shift the result substantially, especially when diameters are rounded aggressively. Use this tool as a rapid estimation aid and as a teaching tool for understanding how bedside formulas work. It is not a substitute for formal radiology review, specialist interpretation, or serial imaging. When treatment decisions are urgent, the trend in the patient’s examination and the anatomy of the bleed remain just as important as the numeric volume estimate.