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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Head injury introduction
• What are the causes of head injury?
• What are the symptoms of a head injury?
• What is the Glasgow Coma Scale?
• When should I contact a doctor about a head injury?
• How is a head injury diagnosed?
• How is a head injury treated?
• What is the prognosis for a head injury?
• How can a head injury be prevented?
• What about a head injury in infants and young children?
• Head Injury At A Glance
• Patient Comments: Head Injury - Cause
• Find a local Doctor in your town
• Head Injury Index

The Glasgow Coma Scale was developed to provide health care practitioners a simple way of measuring the depth of coma based upon observations of eye opening, speech, and movement. Patients in the deepest level of coma:

• do not respond with any body movement to pain,
  
  
• do not have any speech, and
  
  
• do not open their eyes.

Those in lighter comas may offer some response, to the point they may even seem wake, yet meet the criteria of coma because they do not respond to their environment.

An awake person has a Glasgow Coma Scale of 15, while a person who is dead would have a score of 3. The abnormal motor responses of flexion and extension describe arm and leg movement when a painful stimulus is applied. The term "decorticate" means that the cortex of the brain, the part that deals with movement, sensation, and thinking, is not working. "Decerebrate" means that the cerebrum, the cortex, and the brain stem that controls basic bodily functions like breathing and heart beat, is not working.

The scale is used as part of the initial evaluation of a patient, but does not assist in making the diagnosis as to the cause of coma. Since it "scores" the level of coma, the GCS can be used as a standard method for any health care practitioner to assess change in patient status.