Glasgow Coma Scale

Background

Distribution of GCS in traumatic brain injury

• Abbreviation: GCS

Scoring

Adult GCS

Eye Opening	Verbal	Motor
		6: Obeys commands
	5: Oriented	5: Localizes to pain
4: Spontaneously opens	4: Confused speech	4: Withdraws from pain (normal flexion)
3: Opens to command	3:Inappropriate words	3: Decorticate posturing (abnormal flexion)
2: Opens to pain	2: Incomprehensible sounds	2: Decerebrate posturing (extension)
1: Does not open	1: No response	1: No response

• 14-15: Mild
• 9-13: Moderate
• 3-8: Severe

Pediatric GCS

Eye Opening	Verbal	Motor
		6: Normal spontaneous movement
	5: Smiles, coos, babbles	5: Withdraws to touch
4: Opens eyes spontaneously	4: Irritable, crying (but consolable)	4: Withdraws to pain
3: Opens eyes to speech only	3:Inconsolable crying or crying only in response to pain	3: Abnormal flexion to pain (Decorticate response)
2: Opens eyes to pain only	2: Moans in response to pain	2: Abnormal extension to pain (Decerebrate response)
1: Does not open eyes	1: No response	1: No response

Note:

• For Motor score 4, pain is defined flat, fingernail pressure (often performed with the barrel of a pencil).
• For Motor scores 2 and 3, pain is defined by pressing hard on the supraorbital notch. If this unsuccessful, sternal pressure may also be attempted.

See Also

• Blunt head trauma
• Altered Mental Status
• Trauma (Peds)
• Altered mental status (peds)
• Pediatric head trauma

External Links

• MDCalc - Glasgow Coma Scale/Score (GCS)