Neurology Book

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Glasgow Coma Scale

Aka: Glasgow Coma Scale, Pediatric Glasgow Coma Scale, GCS
  1. See Also
    1. Level of Consciousness
    2. Altered Level of Consciousness
    3. AVPU Scale
    4. Coma Exam
    5. FOUR Score Coma Exam (Full Outline of Unresponsiveness)
  2. Indications
    1. Head Injury
  3. Scoring
    1. Eye Opening
      1. Spontaneous: 4
      2. To speech: 3
      3. To pain: 2
      4. No Response: 1
    2. Best Verbal Response
      1. Oriented (Infant coos or babbles): 5
      2. Confused (Infant irritable cries): 4
      3. Inappropriate words (Infant Cries to pain): 3
      4. Incomprehensible sounds (Infant Moans to pain): 2
      5. No Response: 1
    3. Best Motor Response
      1. Obeys (Infant moves spontaneous/purposefully): 6
      2. Localizes (infant withdraws to touch): 5
      3. Withdraws to pain: 4
      4. Abnormal Flexion (Decorticate Posturing): 3
      5. Abnormal Extension (Decerebrate Posturing): 2
      6. No Response: 1
  4. Interpretation
    1. Total: 3-15
    2. Mild Head Injury: 13-15 (at two hours post-injury)
    3. Moderate Head Injury: 9-12 (at two hours post-injury)
    4. Severe Head Injury (Coma): <= 8 (at two hours post-injury)
      1. Confers Significant Mortality Risk
  5. References
    1. Morray (1984) Crit Care Med 12: 1018 [PubMed]
    2. Teasdale (1974) Lancet 2:81-4 [PubMed]
    3. Davis (1987) in Rogers, Textbook of Ped Int Care

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