December 21, 2014

Glasgow Coma Scale

There are a few different systems that medical practioners use to diagnose the symptoms of Traumatic Brain Injury.  This section discusses the Glasgow Coma Scale.  Click on the link to find out more information about the Ranchos Los Amigos Scale.

The Glasgow Coma Scale is based on a 15 point scale for estimating and categorizing the outcomes of brain injury on the basis of overall social capability or dependence on others.

The test measures the motor response, verbal response and eye opening response with these values:

I. Motor Response
6 – Obeys commands fully
5 – Localizes to noxious stimuli
4 – Withdraws from noxious stimuli
3 – Abnormal flexion, i.e. decorticate posturing
2 – Extensor response, i.e. decerebrate posturing
1 – No response

II. Verbal Response
5 – Alert and Oriented
4 – Confused, yet coherent, speech
3 – Inappropriate words and jumbled phrases consisting of words
2 – Incomprehensible sounds
1 – No sounds

III. Eye Opening
4 – Spontaneous eye opening
3 – Eyes open to speech
2 – Eyes open to pain
1 – No eye opening

The final score is determined by adding the values of I+II+III.

This number helps medical practioners categorize the four possible levels for survival, with a lower number indicating a more severe injury and a poorer prognosis:

Mild (13-15):

Moderate Disability (9-12):

  • Loss of consciousness greater than 30 minutes
  • Physical or cognitive impairments which may or may resolve
  • Benefit from Rehabilitation

Severe Disability (3-8):

  • Coma: unconscious state.  No meaningful response, no voluntary activities

Vegetative State (Less Than 3):

  • Sleep wake cycles
  • Aruosal, but no interaction with environment
  • No localized response to pain

Persistent Vegetative State:

  • Vegetative state lasting longer than one month

Brain Death:

  • No brain function
  • Specific criteria needed for making this diagnosis

Information about the other tests as well as symptoms and diagnosis can be found in the following sections: