How the Glasgow Coma Scale assesses brain injuries

Used by emergency responders and medical professionals, the Glasgow Coma Scale (GCS) is a quick test of a potential brain injury.

GCS is used by emergency responders to assess potential brain injuries
GCS is used by emergency responders to assess potential brain injuries

The GCS is used for a fast assessment of a head or brain injury at the scene of a car accident, sporting event, or other injury site.

Three factors—a victim’s ability to speak, to move, and to open his or her eyes—are assigned points based on a positive response.

A severe TBI might have an initial score of between 3 and 8 on this scale. A more moderate TBI would fall between 9 and 12. A score of 13-15 would be considered a mild TBI.

Coma Scale for Assessing Brain Injuries

Verbal Response:

  • 5 points = alert, normal speech
  • 4 = alert, but disoriented speech
  • 3 = words, but incoherent speech
  • 2 = sounds, but no words
  • 1 = no response

Eye Opening:

  • 4 points = spontaneous eye opening
  • 3 = eyes open in response to voice
  • 2 = eyes open in response to pain
  • 1 = no response

Motor response:

  • 6 points = normal physical response
  • 5 = localized physical response
  • 4 = withdraws to pain
  • 3 = Abnormal muscle response (such as limb rigidity, clenched fists, legs straight out)
  • 2 = Abnormal body response (such as arms and legs held straight out, toes pointed downward, head and neck arched backwards)
  • 1 = no response

The scale works well for immediate treatment of a potential brain injury, but the long-term implications can be limited. An inaccurate score could be caused by shock, a high blood alcohol level, or other factors.


For more on the Glasgow Coma Scale, visit


Image courtesy of David Castillo Dominici,

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