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Glasgow Coma Scale (GCS)
Standardised neurological assessment — Eye + Verbal + Motor responses
Response Assessment
Pupillary Response
—
Eye (E)
—
Verbal (V)
—
Motor (M)
—
GCS / 15
GCS-Pupils Score: —
GCS minus Pupil Reactivity Score (0=both reactive, 1=one unreactive, 2=both unreactive)
GCS minus Pupil Reactivity Score (0=both reactive, 1=one unreactive, 2=both unreactive)
Motor Laterality: —
Reference
| GCS | Severity | Clinical Action |
|---|---|---|
| 13–15 | Mild TBI | Monitor; CT if indicated |
| 9–12 | Moderate TBI | CT head; neurosurgery consult |
| 3–8 | Severe TBI / Coma | Consider intubation (≤8); urgent imaging |
| 3 | Minimum score | Deep coma; brainstem death evaluation |
GCS = E + V + M (range 3–15)
GCS-Pupils = GCS − Pupil Score
Pupil Score: 0 = both reactive | 1 = one unreactive | 2 = both unreactive
GCS-Pupils = GCS − Pupil Score
Pupil Score: 0 = both reactive | 1 = one unreactive | 2 = both unreactive
Clinical Pearl: GCS ≤8 is the conventional threshold for intubation consideration. Serial measurements are more valuable than a single value. GCS-Pupils score improves 30-day mortality prediction after TBI.
For clinical decision support only. Not a substitute for professional medical judgment. Always integrate with full clinical assessment.
