The Glasgow Coma Scale (GCS) was devised to assess injury severity in a multi-centre study of outcome after severe brain damage. It uses unambiguous terms that are readily understood by a wide range of observers. Giving numbers to responses makes communication and display of responsiveness easy and the overall score allows classifi cation of overall severity of brain injury for triage and for epidemiological studies. The total score involves some loss of predictive information. Outcome correlates well with the early GCS both in head injuries and other intensive care patients. When early sedation and ventilation after head injury makes GCS assessment difficult, the motor score is often available and is a useful index of injury severity. The GCS also facilitates monitoring in the early stages after injury, allowing rapid detection of complications. Even among mild injuries (GCS 13- 15) the scale can discriminate between those more or less likely to have detectable brain damage and to be at risk of complications.
Adams JHGraham DI, Jennett B.2001. The structural basis of moderate disability after traumatic brain damage. J Neurol Neurosurg Psychiatry71: 521-524.
2.
Bassi S, Buxton N, Punt JAet al.1999. Glasgow coma scale: a help or hindrance. Br J Neurosurg13: 526-526.
3.
Bastos PG, Sun X, Wagner DPet al.1993. Glasgow Coma Scale score in the evaluation of outcome in the intensive care unit: findings from the Acute Physiology and Chronic Health Evaluation III study. Crit Care Med21: 1459-1465.
4.
Bates D, Caronna JJ, Cartlidge NEFet al.1977. A prospective study of non-traumatic coma: methods and results in 310 patients. Ann Neurol2: 211-220.
5.
Blumbergs PC, Scott G, Manavis Jet al.1994. Staining of amyloid precursor protein to study axonal damage in mild injury. Lancet344: 1055-1056.
6.
Braakman R, Avezaat CJ, Maas A.1977. Interobserver agreement in the assessment of the motor response of the Glasgow `Coma’ Scale. Clin Neurol Neurosurg80: 100-100.
7.
Gentleman D, Teasdale G.1981. Adoption of Glasgow Coma Scale in the British Isles. Br Med J283: 408-408.
8.
Gomez PA, LobatoRD, Ortega JMet al.1996. Mild head injury: differences in prognosis among patientswith Glasgow Coma Scale score of 13 to 15 and analysis of factors associated with CT findings. Br J Neurosurg10: 453-460.
9.
Jennett B.1979. Defining brain damage after head injury. J Roy Coll Physicians Lond13: 197-200.
10.
Jennett B.1989. Some international comparisons. In: Levin HS, Eisenberg HM, BentonAL eds. Mild head injury. New York: Oxford University Press, 23-34.
11.
Jennett B.1991. Epidemiology of severe head injury: socioeconomic consequences of avoidable mortality and morbidity. In: Scriabine A, Teasdale GM, Tettenborn Det al. eds. Nimodopine: pharmacological and clinical results in cerebral ischaemia. Berlin: Springer-Verlag.
12.
Jennett B, Bond M.1975. Assessment of outcome after severe brain damage. Lancet1: 480-484.
13.
Jennett B, Teasdale G.1977. Aspects of coma after severe head injury. Lancet1: 878-881.
14.
Jennett B, Teasdale G, Galbraith Set al.1977.Severe head injuries in three countries. J Neurol Neurosurg Psychiatry40: 291-298.
15.
Jennett B, Teasdale GM, Knill-Jones RP.1975. Predicting outcome after head injury. J Roy Coll Physicians Lond9: 231-237.
16.
Jepson RP and Whitty CWM.1947. The neurological state and post-operative course of penetrating head wounds. In War Surgery Supplement No.1. 1947. Wounds of the head. Br J Surg243-250.
17.
Kraus JF, Black MA, Hessol Net al.1984.The incidence of acute brain injury and serious impairment in a defined population. Am J Epidemiol119: 186-201.
18.
Langfitt TW.1978. Measuring the outcome from head injuries. J Neurosurg48: 673-678.
19.
Levin HS, Mattis S, Ruff RMet al.1987. Neurobehavioral outcome following minor head injury: a three center study. J Neurosurg66: 234-243.
20.
LivingstoneBM, MackenzieSJ, MacKirdy FNet al.2000.Should the pre-sedation Glasgow Coma Scale value be used when calculating the Acute Physiology and Chronic Health Evaluation scores for sedated patients? Crit Care Med28: 389-394.
21.
Marion DW, Carlier PM.1994. Problems with initial Glasgow Coma Scale assessment caused by prehospital treatment of patients with head injuries: results of a national survey. J Trauma36: 89-95.
22.
Medical Research Council Brain Injuries Committee. 1941. A Glossary of Psychological Terms Commonly Used in Cases of Head Injury. MRC War Memorandum No.4. London: His Majesty’s Stationery Office.
23.
Miller JD, Jennett B.1968. Complications of depressed skull fracture. Lancet2: 991-995.
24.
Morris K.1993. Assessment and communication of conscious level: an audit of neurosurgical referrals. Injury24: 369-372.
25.
Murray GD, Teasdale GM, Braakman Ret al.1999. The EuropeanBrain Injury Consortium Survey of Head Injuries. Acta Neurochir (Wien)141: 223-236.
26.
Nell V, Yates DW, Kruger J.2000. An extended Glasgow Coma Scale(GCS-E) with enhancedsensitivityto mild brain injury. Arch Phys Med Rehabil81: 614-617.
27.
Nissen JJ, Jones PA, Signorini DFet al.1999. Glasgow Head Injury Outcome Prediction Program: an independent assessment. J Neurol Neurosurg Psychiatry67: 796-799.
28.
Prasad K.1996. The Glasgow Coma Scale: a critical appraisal of its clinimetric properties. J Clin Epidemiol49: 755-763.
29.
Reilly PL, Adams JH, Graham DI, JennettB.1975. Patients with head injury who talk and die. Lancet2: 375-377.
30.
Rimel RW, Giordani MA, Barth JTet al.1981. Disability caused by minor injury. Neurosurgery9: 221-228.
31.
Rimel RW, Giordani MA, Barth JTet al.1982. Moderate head injury: completing the clinical spectrum of brain trauma. Neurosurgery11: 344-351.
32.
Rish BL, Caveness WF, Dillon JDet al.1981. Analysis of brain abscess after penetrating craniocerebral injuries in Vietnam. Neurosurgery9: 535-541.
33.
Rowley G, Fielding K.1991. Reliability and accuracy of the Glasgow Coma Scale with experienced and inexperienced users. Lancet337: 535-538.
34.
Salazar AM, Jabbari B, Vance SCet al.1985. Epilepsy after penetrating head injury. I. Clinical correlates: a report of the Vietnam Head Injury Study. Neurology35: 1406-1414.
35.
Servadei F, Teasdale G, Merry G, on behalf of the Neurotraumatology Committee of the World Federation of Neurosurgical Societies. 2001. Defining acute mild head injury in adults: a proposal based on prognostic factors, diagnosis and management. J Neurotrauma18: 657-664.
36.
Stiell IG, Wells GA, Vandemheen Ket al.2001.The Canadian CT Head Rule for patients with minor head injury. Lancet357: 1391-1396.
37.
Swann IJ, Teasdale GM.1999. Current concepts in the management of patients with so-called `minor’ or `mild’ head injury. Trauma1: 143-155.
Teasdale GM, Galbraith S, Clarke K.1975. Acute impairment of brain function<Eth>2: observation record chart. Nurs Times71: 972-973.
40.
Teasdale G, Gentleman D.1982. The description of `conscious level’: a case for the Glasgow Coma Scale. Scot Med J27: 7-9.
41.
Teasdale G, Jennett B.1974. Assessment of coma and impaired consciousness: a practical scale. Lancet2: 81-84.
42.
Teasdale G, Jennett B.1976. Assessment and prognosis of coma after head injury. Acta Neurochir (Wien)34: 45-55.
43.
Teasdale G, Jennett B, Murray Let al.1983. Glasgow Coma Scale: to sum or not to sum. Lancet2: 678-678.
44.
Teasdale G, Knill-Jones R, van der Sande J.1978. Observer variability in assessing impaired consciousness and coma. J Neurol Neurosurg Psychiatry41: 603-610.
45.
Teasdale GM, Murray L.2000. Revisiting the Glasgow Coma Scale and Score. Intens Care Med26: 153-154.
46.
Teasdale G, Murray G, Parker Let al.1979. Adding up the Glasgow Coma Score. Acta Neurochir28(supp): 13-16.
47.
Teoh LSG, Gowardman JR, Larsen PDet al.2000. Glasgow Coma Scale: variation in mortality among permutations of specific total scores. Intens Care Med26: 157-161.
48.
Teres D, Brown RB, Lemeshow S.1982. Predicting mortality of intensive care unit patients: the importance of coma. Crit Care Med10: 86-95.
49.
Thornhill S, Teasdale GM, Murray GDet al.2000. Disability in young people and adults one year after head injury: prospective cohort study. Br Med J320: 1631-1635.
50.
War Surgery Supplement No.1. 1947. Wounds of the head. Br J Surg.
51.
Weiss GH, Feeney DM, Caveness WFet al.1983. Prognostic factors for the occurrence of post-traumatic epilepsy. Arch Neurol40: 7-10.
52.
Wilson JTL, Teasdale GM, Hadley DMet al.1994. Post-traumatic amnesia: still a valuable yardstick. J Neurol Neurosurg Psychiatry57: 198-201.
53.
Windler JV, Rosen P, Altrey ES.1984. Pre-hospital use of the Glasgow Coma Scale in severe head injury. J Emerg Med2: 1-6.
