# sICH score

sICH

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/sich`
HTML: https://magentlab.com/docs/sich
Markdown: https://magentlab.com/docs/sich.md

Not a medical device. Not a diagnosis, dose, or listing recommendation.

## What it computes

Sum the four Cucchiara 2008 sICH flags and return the 0-4 total plus that paper's any-ICH percents (2.6/9.7/15.1/37.9% for scores 0/1/2/>=3).

## When to use

When an agent has caller-assigned age >60, NIHSS >10, glucose >150 mg/dL, and platelets <150,000/mm3 flags and needs the published sICH total and any-ICH percents, without inventing NIHSS, lab values, or later unofficial hemorrhage percents.

## When not to use

- Not a medical device.
- Not a tPA order, withhold, or thrombolysis decision.
- Not a hemorrhage diagnosis.
- magent does not assay glucose or platelets or compute NIHSS. The caller assigns the four Cucchiara 2008 flags (age >60 years, baseline NIHSS >10, baseline glucose >150 mg/dL / 8.325 mmol/L, baseline platelets <150,000/mm3).
- Any-ICH percents are Cucchiara 2008: 2.6% (0), 9.7% (1), 15.1% (2), 37.9% (>=3). Scores 3 and 4 both return 37.9. magent does not invent later unofficial hemorrhage percents.

## Formula

```
sICH = age_gt_60 + nihss_gt_10 + glucose_gt_150 + platelets_lt_150k; each 1; Cucchiara 2008; max 4; any ICH 2.6/9.7/15.1/37.9% for scores 0/1/2/>=3; caller-assigned flags; magent does not assay glucose or platelets or compute NIHSS
```

## Citation

[A risk score to predict intracranial hemorrhage after recombinant tissue plasminogen activator for acute ischemic stroke](https://doi.org/10.1016/j.jstrokecerebrovasdis.2008.03.012)
Cucchiara B, Tanne D, Levine SR, Demchuk AM, Kasner SE
J Stroke Cerebrovasc Dis. 2008;17(6):331-333
DOI: [10.1016/j.jstrokecerebrovasdis.2008.03.012](https://doi.org/10.1016/j.jstrokecerebrovasdis.2008.03.012)

## Worked example

### All flags false

Given: `age_gt_60=false, glucose_gt_150=false, nihss_gt_10=false, platelets_lt_150k=false`

1. age_gt_60, nihss_gt_10, glucose_gt_150, and platelets_lt_150k are false
2. score = 0 (max 4); any ICH 2.6%


### All flags true

Given: `age_gt_60=true, glucose_gt_150=true, nihss_gt_10=true, platelets_lt_150k=true`

1. All four Cucchiara 2008 flags true, 1 point each
2. score = 4 (max 4); any ICH 37.9% (published >=3 bucket)


## Also searched as

- sICH score
- Cucchiara score
- Cucchiara 2008 ICH
- post-tPA ICH score
- Multicenter Stroke Survey ICH
- rtPA hemorrhage risk score
- Cucchiara hemorrhage score
- symptomatic ICH Cucchiara

## Parameters

- `age_gt_60` (boolean, required): Age >60 years as assigned by the caller (Cucchiara 2008). true or false. magent does not assign age from a numeric value.
- `nihss_gt_10` (boolean, required): Baseline NIHSS >10 as assigned by the caller (Cucchiara 2008). true or false. magent does not compute NIHSS or examine the patient.
- `glucose_gt_150` (boolean, required): Baseline glucose >150 mg/dL (8.325 mmol/L) as assigned by the caller (Cucchiara 2008). true or false. magent does not assay glucose or convert units.
- `platelets_lt_150k` (boolean, required): Baseline platelet count <150,000/mm3 as assigned by the caller (Cucchiara 2008). true or false. magent does not assay platelets.

## Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

Method: `POST /api/calc/sich`
Max items: 25
Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic)
Status: PREVIEW

- 1 to 25 items. Each item uses the same keys as the GET query parameters.
- POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
- The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
- HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
- Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
- x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request:

```json
{
  "items": [
    {
      "age_gt_60": "false",
      "glucose_gt_150": "false",
      "nihss_gt_10": "false",
      "platelets_lt_150k": "false"
    },
    {
      "age_gt_60": "false",
      "glucose_gt_150": "false",
      "nihss_gt_10": "false",
      "platelets_lt_150k": "false"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/sich

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/sich",
  "items": [
    {
      "components": [
        {
          "factor": "age_gt_60",
          "points": 0,
          "present": false
        },
        {
          "factor": "nihss_gt_10",
          "points": 0,
          "present": false
        },
        {
          "factor": "glucose_gt_150",
          "points": 0,
          "present": false
        },
        {
          "factor": "platelets_lt_150k",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Cucchiara B, Tanne D, Levine SR, Demchuk AM, Kasner SE",
        "doi": "10.1016/j.jstrokecerebrovasdis.2008.03.012",
        "id": "cucchiara-2008",
        "pmid": "18984422",
        "source": "J Stroke Cerebrovasc Dis. 2008;17(6):331-333",
        "title": "A risk score to predict intracranial hemorrhage after recombinant tissue plasminogen activator for acute ischemic stroke"
      },
      "formula": "sich",
      "formula_expression": "sICH = age_gt_60 + nihss_gt_10 + glucose_gt_150 + platelets_lt_150k; each 1; Cucchiara 2008; max 4; any ICH 2.6/9.7/15.1/37.9% for scores 0/1/2/>=3; caller-assigned flags; magent does not assay glucose or platelets or compute NIHSS",
      "max_score": 4,
      "score": 0,
      "any_ich_percent": 2.6,
      "age_gt_60": false,
      "glucose_gt_150": false,
      "nihss_gt_10": false,
      "platelets_lt_150k": false
    },
    {
      "components": [
        {
          "factor": "age_gt_60",
          "points": 0,
          "present": false
        },
        {
          "factor": "nihss_gt_10",
          "points": 0,
          "present": false
        },
        {
          "factor": "glucose_gt_150",
          "points": 0,
          "present": false
        },
        {
          "factor": "platelets_lt_150k",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Cucchiara B, Tanne D, Levine SR, Demchuk AM, Kasner SE",
        "doi": "10.1016/j.jstrokecerebrovasdis.2008.03.012",
        "id": "cucchiara-2008",
        "pmid": "18984422",
        "source": "J Stroke Cerebrovasc Dis. 2008;17(6):331-333",
        "title": "A risk score to predict intracranial hemorrhage after recombinant tissue plasminogen activator for acute ischemic stroke"
      },
      "formula": "sich",
      "formula_expression": "sICH = age_gt_60 + nihss_gt_10 + glucose_gt_150 + platelets_lt_150k; each 1; Cucchiara 2008; max 4; any ICH 2.6/9.7/15.1/37.9% for scores 0/1/2/>=3; caller-assigned flags; magent does not assay glucose or platelets or compute NIHSS",
      "max_score": 4,
      "score": 0,
      "any_ich_percent": 2.6,
      "age_gt_60": false,
      "glucose_gt_150": false,
      "nihss_gt_10": false,
      "platelets_lt_150k": false
    }
  ]
}
```

## Response fields

- `formula` (string): sich
- `formula_expression` (string): Exact expression used
- `score` (integer): sICH points 0-4
- `max_score` (integer): Always 4
- `any_ich_percent` (number): Cucchiara 2008 any-ICH percent: 2.6 (0), 9.7 (1), 15.1 (2), 37.9 (>=3). Scores 3 and 4 both 37.9.
- `age_gt_60` (boolean): Whether age >60 years was assigned
- `nihss_gt_10` (boolean): Whether baseline NIHSS >10 was assigned
- `glucose_gt_150` (boolean): Whether baseline glucose >150 mg/dL was assigned
- `platelets_lt_150k` (boolean): Whether baseline platelets <150,000/mm3 were assigned
- `components` (array): Per-factor Cucchiara 2008 points
- `citation` (object): Cucchiara 2008 J Stroke Cerebrovasc Dis citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "factor": "age_gt_60",
      "points": 0,
      "present": false
    },
    {
      "factor": "nihss_gt_10",
      "points": 0,
      "present": false
    },
    {
      "factor": "glucose_gt_150",
      "points": 0,
      "present": false
    },
    {
      "factor": "platelets_lt_150k",
      "points": 0,
      "present": false
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Cucchiara B, Tanne D, Levine SR, Demchuk AM, Kasner SE",
    "doi": "10.1016/j.jstrokecerebrovasdis.2008.03.012",
    "id": "cucchiara-2008",
    "pmid": "18984422",
    "source": "J Stroke Cerebrovasc Dis. 2008;17(6):331-333",
    "title": "A risk score to predict intracranial hemorrhage after recombinant tissue plasminogen activator for acute ischemic stroke"
  },
  "formula": "sich",
  "formula_expression": "sICH = age_gt_60 + nihss_gt_10 + glucose_gt_150 + platelets_lt_150k; each 1; Cucchiara 2008; max 4; any ICH 2.6/9.7/15.1/37.9% for scores 0/1/2/>=3; caller-assigned flags; magent does not assay glucose or platelets or compute NIHSS",
  "max_score": 4,
  "score": 0,
  "any_ich_percent": 2.6,
  "age_gt_60": false,
  "glucose_gt_150": false,
  "nihss_gt_10": false,
  "platelets_lt_150k": false
}
```

## Errors

- HTTP 400 `invalid_sich`: sICH score inputs must match Cucchiara 2008 age, NIHSS, glucose, and platelet flags from that paper. Returned before settlement; you are not charged.
- HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
- HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
- HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged.

Shared HTTP 402 and 503: https://magentlab.com/docs/payments

## Related tools

- [NIHSS](https://magentlab.com/docs/nihss) — Sum Brott 1989 NIH stroke scale points from 15 caller-assigned examination integers, including pupillary response and plantar reflex. Weaker-limb motor arm and leg. Does not apply later total-score severity bands.
- [ICH Score](https://magentlab.com/docs/ich-score) — Compute the Hemphill 2001 ICH Score from caller-assigned GCS, age, infratentorial origin, ICH volume, and IVH.
- [HAT](https://magentlab.com/docs/hat) — Compute the Lou 2008 HAT (Hemorrhage After Thrombolysis) score for symptomatic intracranial hemorrhage after stroke thrombolysis from diabetes or baseline glucose >200 mg/dL, pretreatment NIHSS, and easily visible hypodensity on initial CT.

## Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s.

- GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall).
- HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote.
- Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering.
- Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional.
- Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402.

- offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront.
- offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization.

- not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search.

Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers).

Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments

Stdio MCP (one process per host): https://magentlab.com/docs/mcp

## Guarantees

- HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
- exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
- HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
- Execution is timeout-bounded and concurrency-capped.
- Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.