What is the role of the Glasgow Coma Scale (GCS) in the classification of traumatic brain injury (TBI) severity?

Updated: Feb 01, 2018
  • Author: Percival H Pangilinan, Jr, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Answer

The most common classification system for TBI severity is based on the Glasgow Coma Scale (GCS) score determined at the time of injury. The GCS is a 3- to 15-point scale used to assess a patient's level of consciousness and level of neurologic functioning. [3, 4] It consists of 3 sections, each of which is scored: best motor response, best verbal response, and eye opening (Table 1). A total score of 3-8 for the 3 sections indicates severe TBI, a score of 9-12 indicates moderate TBI, and a score of 13-15 indicates mild TBI.

Table 1. Glasgow Coma Scale (Open Table in a new window)

Score

Best Motor Response

Best Verbal Response

Eye Opening

1

None

None

None

2

Decerebrate posturing

Mutters unintelligibly

Opens to pain

3

Decorticate posturing

Inappropriate speech

Opens to command

4

Withdraws to pain

Confused

Opens spontaneously

5

Localizing response to pain

Alert and oriented

NA

6

Obeys commands

NA

NA

Total*

1-6

1-5

1-4

Source—Teasdale and Jennett, 1974. [4]

Note—NA = not applicable.

* The total of the motor, verbal, and eye-opening scores (range, 3-15) indicates the severity of a TBI, as follows: 3-8 is severe TBI, 9-12 is moderate TBI, and 13-15 is mild TBI.


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