In order to develop a practical classification of spontaneous intraventricular haemorrhage (IVH), a correlation was made between clinical and computed tomographic (CT) factors in 324 patients with IVH between September 1988 and December 1996. Spontaneous IVH was graded according to age, blood pressure, clinical conditions, conscious state on admission, primary site of bleeding, volume of intraparenchymal haematoma, degree of midline shift, degree of hydrocephalus and location of IVH, producing a score up to 20. A score of 0-5 was Grade I, 6-10 Grade II, 11-15 Grade III, 16-20 Grade IV. The mortality of each Grade, respectively, was 1.6%, 22.5%, 76% and 100%. The authors propose that this grading system may be a practical schema in the evaluation of the prognosis for IVH.