Glasgow Coma Scale - Adult

The Glasgow Coma Scale (GCS) is used to describe the general level of consciousness in patients with traumatic brain injury (TBI) and to define broad categories of head injury. ^[1] The GCS is divided into 3 categories, eye opening (E), motor response (M), and verbal response (V). The score is determined by the sum of the score in each of the 3 categories, with a maximum score of 15 and a minimum score of 3, as follows:

GCS score = E + M + V

Also see Medscape’s Glasgow Coma Scale Calculator.

Eye opening scores

See the list below:

• 4: Spontaneously

• 3: To verbal command

• 2: To pain

• 1: No response

Best motor response scores

See the list below:

• 6: Obeys command

• 5: Localizes pain

• 4: Flexion withdrawal

• 3: Flexion abnormal (decorticate)

• 2: Extension (decerebrate)

• 1: No response

Best verbal response scores

See the list below:

• 5: Oriented and converses

• 4: Disoriented and converses

• 3: Inappropriate words; cries

• 2: Incomprehensible sounds

• 1: No response

Interpretation

Patients who are intubated are unable to speak, and their verbal score cannot be assessed. They are evaluated only based on eye opening and motor scores, and the suffix T is added to their score to indicate intubation. In intubated patients, the maximum GCS score is 10T and the minimum score is 2T. The GCS is often used to help define the severity of TBI. Mild head injuries are generally defined as those associated with a GCS score of 13-15, and moderate head injuries are those associated with a GCS score of 9-12. A GCS score of 8 or less defines a severe head injury. These definitions are not rigid and should be considered as a general guide to the level of injury.