What Is the Glasgow Coma Scale?

Brain injuries can change one’s life in a second. From mild concussions to severe traumatic brain injuries (TBIs), brain injuries affect everything from cognitive function to motor skills and overall quality of life.

The severe consequences of brain injuries require medical professionals to be able to quickly and accurately diagnose the severity of injuries to the head. One of the most widely used tools for assessing consciousness after a head injury is the Glasgow Coma Scale (GCS). The Glasgow Coma Scale is a standardized system that measures a patient’s level of responsiveness following a traumatic event.

The Glasgow Coma Scale was first used in 1974 and is still used because of its accuracy and simplicity. The GCS assigns a numerical score based on three key responses to external stimuli: eye-opening, verbal response, and motor response. Each response is rated on a scale. Higher scores indicate a greater level of consciousness, while lower scores suggest more severe impairment.

The three key responses measured by the Glasgow Coma Scale

The Glasgow Coma Scale evaluates a patient’s ability to respond to stimuli after suffering to the head or brain:

Eye-opening

1. Spontaneous (4 points): The patient’s eyes open naturally, indicating a level of alertness.
2. To sound (3 points): The patient opens their eyes in response to a verbal stimulus.
3. To pressure (2 points): The patient only opens their eyes in response to physical stimulation, such as a painful stimulus.
4. No response (1 point): The patient’s eyes remain closed, showing no reaction.

Eye-opening responses give insight into overall neurological alertness. If a patient’s eyes do not respond to any stimulus, it may suggest significant brain dysfunction or coma.

Verbal response

1. Oriented (5 points): The patient can answer questions about who they are and what time it is and can converse normally.
2. Confused (4 points): The patient can speak and answer questions but is confused and disoriented.
3. Inappropriate words (3 points): Speech is present but nonsensical or unrelated to the question asked.
4. Incomprehensible sounds (2 points): Moaning or groaning, with no recognizable speech patterns.
5. No response (1 point): No verbal response at all.

A patient who cannot speak coherently or makes incomprehensible sounds likely has significant brain impairment.

Motor response

1. Obeys commands (6 points): The patient can follow simple motor instructions, such as squeezing a hand or raising an arm.
2. Localizes pain (5 points): The patient reacts to painful stimuli by moving toward the source.
3. Withdraws from painful stimuli (4 points): A reflexive movement away from pain is present but lacks direction.
4. Abnormal flexion (3 points): Also called “decorticate posturing,” the patient flexes their arms over the chest and extends their feet outward.
5. Abnormal extension (2 points): Known as “decerebrate posturing,” the patient’s head arches backward while the arms and legs extend and rotate internally.
6. No response (1 point): No voluntary movement or reaction to stimuli.

Motor responses show if and how well the brain communicates with the rest of the body. Abnormal posturing or complete lack of movement may indicate severe traumatic brain injury or damage to the brainstem.

What do GCS scores indicate?

The total GCS score is obtained by adding the scores from all three categories. This results in a score between 3 and 15. The scores are categorized as follows:

• Mild brain injury (GCS 13–15): Patients are generally cognizant, conscious, and aware. However, they may be disoriented or confused. Most concussions fall into this range. In general, recovery is usually expected with minimal long-term effects.
• Moderate brain injury (GCS 9–12): Patients show significant impairment in cognitive or motor functions. They may require hospitalization with close monitoring to prevent further complications.
• Severe brain injury (GCS 3–8): Patients with a GCS score of 8 or below are often in a coma. They are at high risk for permanent brain damage or death. Immediate medical intervention is necessary.

How is the Glasgow Coma Scale used in personal injury cases?

Because a patient is scored on the GCS by medical professionals soon after an injury, it serves as an objective conjecture as to the severity of the injury and quantifies the risk of future complications. A brain injury lawyer can use the GCS score to work towards winning compensation for not only immediate medical needs but those of the future as well.

Assessing brain injury severity

Quantifying neurological function is a critical step in any personal injury claim involving head trauma. From a legal standpoint, a low GCS score serves as objective evidence of severe brain injuries. Insurance companies (and their lawyers) frequently attempt to devalue brain injury claims. They often allege symptom exaggeration or attribute cognitive deficits to preexisting conditions. A recorded GCS score provides an objective counterpoint to such arguments.

Establishing the need for compensation

The GCS score is a pivotal factor in determining the long-term financial impact of brain injuries. A lower score at initial assessment often correlates with a greater likelihood of permanent disability, supporting claims for:

• Medical expenses, including emergency intervention, surgeries, rehabilitative therapy, and ongoing treatment.
• Loss of income and diminished future earning potential due to cognitive or physical impairments.
• Pain and suffering, including emotional distress and reduced quality of life.
• Long-term care requirements, including in-home assistance and institutional care.

For example, a patient with a GCS score of 5 may require continuous medical supervision and long-term (or even permanent) assisted living arrangements. The costs can be substantial. An experienced brain injury lawyer fights so that not only are the immediate expenses compensated for, but so are the long-term consequences.

Strengthening expert testimony and legal arguments

Medical experts play a central role in personal injury cases involving traumatic brain injuries (TBIs). The GCS score, when paired with imaging procedures (e.g., CT scans, MRIs), strengthens expert testimony by offering measurable indicators of neurological dysfunction. A brain injury lawyer can leverage this data to:

• Support medical expert opinions regarding the extent of impairment.
• Present objective medical documentation demonstrating injury severity.
• Challenge insurance company tactics aimed at minimizing claims.

Insurers and defense attorneys may often argue for a low valuation of damages. However, a brain injury lawyer can use the GCS to highlight how severe a traumatic brain injury (TBI) is.

For example, if a patient has a GCS score of 7 upon hospital admission, a brain injury attorney can argue that the injury was significant to attending medical personnel. The simple nature of the GCS can combat insurance stalling tactics before they even begin.

Obtaining legal representation from a brain injury claim

Receiving full compensation for a brain injury requires a brain injury lawyer capable of negotiating with insurers. A brain injury attorney assists in:

• Obtaining medical records, including GCS assessments, to support your claims.
• Consulting with medical professionals who can explain the extent of the injury to the court.
• Negotiating with insurers to reach a fair settlement.
• Initiating a lawsuit if settlement negotiations fail.
• Incorporating future medical and care costs into the damage calculations.

Brain injuries result in disruptions to daily life, financial stability, and long-term well-being.  A brain injury lawyer can deal with the insurers while you and your loved ones focus on the recovery that you deserve.

If you or a loved one has experienced a brain injury in the Chicago area, the attorneys at Gainsberg Injury and Accident Lawyers can work to provide a roadmap to recovery. Please call our office or use our contact form to schedule a free consultation.