Evaluating Traumatic Brain Injury

“Neuropsychological impairments caused by brain injury may be characterized in terms of three functional systems (1) intellect which is the information-handling aspect of behavior; (2) emotionality, which concerns feelings and motivations; and (3) control, which has to do with how behavior is expressed.”

“Brain damage rarely affects just one of these systems. Rather, the disruptive effects of most brain injuries, regardless of their size or location, usually involve all three systems.”
One method to evaluate Brain Injury is the Glasgow Coma Scoring System.

Glasgow Coma Score

The GCS is scored between 3 and 15, 3 being the worst, and 15 the best. It is composed of three parameters : Best Eye Response, Best Verbal Response, Best Motor Response, as given below:

Best Eye Response. (4)
1. No eye opening.
2. Eye opening to pain.
3. Eye opening to verbal command.
4. Eyes open spontaneously.

Best Verbal Response. (5)
1. No verbal response
2. Incomprehensible sounds.
3. Inappropriate words.
4. Confused
5. Orientated

Best Motor Response. (6)
1. No motor response.
2. Extension to pain.
3. Flexion to pain.
4. Withdrawal from pain.
5. Localising pain.
6. Obeys Commands.

Note that the phrase ‘GCS of 11’ is essentially meaningless, and it is important to break the figure down into its components, such as E3V3M5 = GCS 11.

A Coma Score of 13 or higher correlates with a mild brain injury, 9 to 12 is a moderate injury and 8 or less a severe brain injury.
Teasdale G., Jennett B., LANCET (ii) 81-83, 1974.