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Glasgow Coma Scale

Overview

The Glasgow Coma Scale is a neurological assessment tool to measure the severity of brain injury based on a patient's response to stimuli. It assigns a score ranging from 3 to 15, with higher scores indicating better neurological function.

The GCS is used in patients with:

  • Head injury or trauma
  • Stroke
  • Brain infections (e.g., meningitis, encephalitis)
  • After surgery or anaesthesia to monitor recovery
  • Critical illness where brain function may be affected
  • Coma evaluation

The healthcare provider checks:

  • Eye opening response (whether the patient opens eyes spontaneously, to sound, to pain, or not at all)
    • Spontaneous: 4 points
    • To verbal stimuli, command, speech: 3 points
    • To pain only: 2 points
    • No response: 1 point 

 

  • Verbal response (whether the patient is oriented, confused, uses inappropriate words, incomprehensible sounds, or is unresponsive)
    • Oriented: 5 points
    • Confused conversation, but able to answer questions: 4 points
    • Inappropriate words: 3 points
    • Incomprehensible speech: 2 points
    • No response: 1 point 

 

  • Motor response (whether the patient obeys commands, localises to pain, withdraws, shows abnormal posturing, or no movement)
    • Obeys commands: 6 points
    • Purposeful movement to painful stimulus: 5 points
    • Withdraws in response to pain: 4 points
    • Flexion in response to pain (decorticate posturing): 3 points
    • Extension response in response to pain (decerebrate posturing): 2 points
    • No response: 1 point

 

  • Each category is scored, and the total score is calculated (3–15).
    • Mild injury: 13–15
    • Moderate injury: 9–12
    • Severe injury: ≤ 8

The test takes just a few minutes and can be repeated multiple times to monitor changes.

  • No special preparation is needed.
  • The test is usually performed at the bedside, often in emergency or ICU settings.

  • The test itself is completely safe and non-invasive.
  • If pain stimulus is applied (e.g., gentle pressure on the nail bed or chest), it may cause brief discomfort but does not cause harm.

  • No recovery time is needed after the test.
  • Results are immediately available and guide further management.

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.