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.
The Glasgow Coma Scale and Long-Term Prognosis
Many people want to know if the Glasgow Coma Scale has any long-term meaning. They have questions like, “Does the score indicate future prognosis?” and “Can I tell what kinds of disabilities my loved ones will have based on the score?”
Simply put, the eye, verbal, and motor responses of a brain injury survivor 24 hours after the accident can indicate—to some degree—the eventual outcome. For example, a person with a best score in the 11 to 15 range, on the other hand, have a high likelihood—close to 90 percent—of making an almost full or full recovery.
However, it’s extremely important to stress that the Glasgow Coma Scale is not an exact science. While statistically those with higher scores tend to have better outcomes, brain injuries are as individual as people themselves. Some people with very low scores have gone on to make almost complete recoveries, while those with high scores have suffered from lifelong disabilities. So while the scale can serve as a guide, it’s impossible to base a long-term prognosis solely on this scale. Nor is it possible to determine the types of disability the survivor will face based on the scale. When it comes to definitely determining the long-term prognosis of a brain injury, the best indicator is time.
Additional Resources
BrainInjury.net is a comprehensive resource for medical and legal information related to catastrophic brain injury.
The Dana Guide to Brain Trauma, Concussion and Coma
Many interesting brain facts
A list of support organizations at the bottom of this page.
Simplified explanation of contra coup injury.