Glasgow Coma Scale (GCS)

1. What are three commonly used indicators of how severe a TBI is?
2. What are the three components to the GCS and how many points is each measured out of? Which is the best predictor of outcome?
3. What GCS score is the cutoff for coma? What range indicates severe injury? Moderate injury? Mild injury?
4. What is the Glasgow-Liege Scale and what does it measure?

Answers:
1. Best GCS within 24 hours of injury, length of coma, and duration of posttraumatic amnesia.
2. Motor (6), Verbal (5), Eyes (4), score 3 to 15. Motor is the best predictor of outcome.
3. GCS <8 is comatose. Score 3-8 is severe injury, 9 to 12 is moderate injury, 13-15 is mild injury.
4. This adds brainstem reflexes: the fronto-orbicular reflex (orbicularis oculi contraction with glabella percussion), oculovestibular reflex ("Doll's eyes" maneuver), pupillary light reflex, oculocardiac reflex (bradycardia caused by pressure on eyeball).