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Overview :
The Glasgow coma scale is used to assess patients in coma.
The initial score correlates with the severity of brain injury and prognosis.
Glasgow coma scale =
= (score for eye opening) + (score for best verbal response)
+ (score for best motor response)
|
Eye
Opening |
Score |
|
spontaneously |
4 |
|
to verbal stimuli |
3 |
|
to pain |
2 |
|
never |
1 |
|
Best Verbal
Response |
Score |
|
oriented and converses |
5 |
|
disoriented and converses |
4 |
|
inappropriate words |
3 |
|
incomprehensible sounds |
2 |
|
no response |
1 |
|
Best Motor
Response |
Score |
|
obeys commands |
6 |
|
localizes pain |
5 |
|
flexion withdrawal |
4 |
|
abnormal flexion (decorticate rigidity) |
3 |
|
extension (decerebrate rigidity) |
2 |
|
no response |
1 |
Interpretation:
• maximum score is 15 which has the best prognosis
• minimum score is 3 which has the worst prognosis
• scores of 8 or above have a good chance for recovery
• scores of
3-5 are potentially fatal, especially if accompanied by fixed pupils or absent
oculovestibular responses
• young
children may be nonverbal, requiring a modification of the coma scale for
evaluation (see next section)
Outcome and Glasgow Coma Scale
|
Highest Score observed during 1st 24
hours after injury |
Good Recovery or Moderate
Disability |
Vegetative or
Dead |
|
3-4 |
7% |
87% |
|
5-7 |
34% |
53% |
|
8-10 |
68% |
27% |
|
11-15 |
82% |
12% |
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