Max-ICH score: Can it prevent self-fulfilling prophecy in ICH?

Prediction of outcomes of patients with spontaneous intracerebral hemorrhage (ICH) can be helpful for patients, their families, and physicians when deciding on treatment strategies, including consideration of withdrawal of care. The most recent American Heart Association guideline for the management of spontaneous ICH recommends the routine use of a standardized severity score to “help streamline assessment and communication between providers.”1 However, it warns that “severity scales should not be used as a singular indicator of prognosis.”