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Describing Brain Injury Severity with the Glasgow Coma Scale

“Coma” Isn’t a Specific Diagnosis

Many brain injuries, whether mild or severe, result in loss of consciousness—at least for a few seconds. A coma is a sustained period of unconsciousness, and it signals moderate or severe brain damage. When a patient is in a coma, there is no way to tell what specific damage has been done or whether they will be able to recover. To classify injuries in this state, doctors use the Glasgow Coma Scale.

Why a Coma Scale?

Because doctors cannot learn the specifics of a brain injury before a patient comes back to full consciousness, they need another way to determine the severity of the condition. The Glasgow Coma Scale was originally created to rate patient condition after a traumatic brain injury but is now used for all acquired brain injuries. Patients’ responses to certain stimuli are tested and then rated on a numerical scale (with 1 being “no response”). The higher a patient’s score, the less severe their injury.

What Can the Glasgow Coma Scale Tell Us?

The Glasgow Coma Scale is useful in helping you understand how serious a loved one’s injuries may be and how likely they are to survive. Doctors may also use increasing scores to determine when a patient is likely to regain consciousness. A higher score can also indicate that rehabilitation is more likely to help the patient regain lost functions, but it does not guarantee they will have an extensive or complete recovery.

What Can’t the Glasgow Coma Scale Tell Us?

The scale cannot predict a patient’s outcome. A coma is a symptom of a problem—and depending on its cause, a person’s likelihood of survival and recovery may vary. Often, comas co-occur with other injuries, which may also affect prognosis. Individual patient factors could even cause two people with identical injuries to have very different outcomes.

Levels of the Glasgow Coma Scale

Doctors test three reactions to determine a patient’s level of consciousness: eye-opening, verbal, and motor (movement) response. The reactions measured for each are:

Eye-Opening Response

  1. Eyes do not open
  2. Eyes open in response to pain
  3. Eyes open in response to sound
  4. Eyes open spontaneously (with no stimulus)

Verbal Response

  1. No verbal response
  2. Makes sounds, but cannot form words
  3. Can form words, but they are random and/or not conversational
  4. Can converse, but is confused and/or disoriented
  5. Can form words and is orientated

Motor Response

  1. No motor response
  2. Extends muscles (straightens at joints) in response to pain
  3. Flexes muscles (bends at joints) in response to pain
  4. Withdraws (moves away from) source of pain
  5. Can identify location of pain
  6. Follows doctor requests

Thus, the Glasgow Coma Scale results in a score between 3 and 15 depending on patients’ reactivity to the world around them. When used on children, especially those too young to speak, doctors base their scores on slightly different feedback. Other factors may also inhibit patients’ responses: Language barriers, hearing loss, or other injuries can interfere with the scale’s measurements.

Determining Coma Severity

The higher a patient’s score on the Glasgow Coma Scale, the better for them (and their loved ones). Here are the groupings doctors use to classify patient conditions:

  • 13-15: Mild, may have normal MRI and CAT scan results
  • 9-12: Moderate disability, likely to have lasting impairment
  • 3-8: Severe disability, likely to have a longer coma

We Can Help If Your Loved One Was Severely Injured

It can be heartbreaking and stressful to see a loved one in a coma. Most brain injuries that cause lasting unconsciousness will result in impairments of some sort; even if a patient is able to fully recover, they may need months or even years of treatment. The costs of high-quality therapies and specialists can get overwhelming, but your loved one deserves the best treatment possible.

You may be able to file a lawsuit if your loved one’s injury was caused by someone else’s actions. Whether accidental or purposeful, causing a life-changing injury has consequences—for the injured and the at-fault party. Talk to our team at Pratt Clay, LLC to see whether you may have a lawsuit.

We always offer free consultations to brain injury victims and their families. Reach out online or call (404) 998-5258 today to speak with one of our compassionate lawyers.