One tool used by medical professionals when assessing a patient for a possible concussion is the Glasgow Coma Scale.  The Glasgow Coma Scale is a 15-point scale used by all sorts of medical professionals to evaluate a patient for level of consciousness and brain function following a head injury.  A score of 13-15 in a patient with a head injury is generally considered to be consistent with a mild or minor brain injury classification (a concussion, or mild traumatic brain injury).  A score of 9 to 12 indicates a moderate traumatic brain injury.  A score below 9 indicates a severe brain injury.  The usefulness of the score is that it allows physicians at the hospital to have a quick, advance understanding of the severity of possible brain injury before the patient arrives in the emergency room.  It is also an indicator of long-term prognosis, in that lower initial GCS scores are correlated with poorer outcomes.  At least one study showed that patients with a GCS of 3 had a mortality rate of 55%, whereas those with a score of 4-8 had a mortality rate of 13%.

What Do The Numbers In The Glasgow Coma Scale Represent?

The test is organized into three parts:

  1. Eye-opening
  2. Verbal Response
  3. Motor Response

A patient can rank from 1 to 4 points in the level of their eye-opening, from 1 to 5 points in the level of their verbal responses, and from 1 to 6 points in their level of motor responsiveness.  For example, if a person's eyes are closed, they would get a score of 1 in the eye-opening category.  If they could not provide any verbal response to prompts, they would get a 1 for the verbal response category.  And if they had no motor response whatsoever, they would get a 1 in that category. 

A person with these scores would receive a score of 3, and would be considered to have a severe TBI.  By contrast, if a person's eyes open spontaneously, they are entirely oriented, and they can obey commands, they get scores of 4, 5, and 6, respectively, which totals 15.  Does this mean they did not suffer a mild TBI (or concussion)?  No, it does not.  It just means that at the time the EMT or other medical professional administered the test, the person exhibited signs consistent with a TBI in the "mild" category.

What Significance Does The Glasgow Coma Scale Scores Have In A Brain Injury?

In our experience, survivors of mild traumatic brain injury, or concussion, will typically have a Glasgow Coma Scale (GCS) reading of 15 in their medical records from the date of the accident.  The reason for that is pretty simple.  A concussion, or mild traumatic brain injury ("mTBI"), is characterized by just a brief, or momentary loss of consciousness, alteration of  mental state, or feeling of being "dazed."  If the patient lost consciousness for some period of time, it is unusual for there to be a third-party witness available who saw the person in an unconscious state who can testify to that fact. 

By the time a medical professional, such as an EMT, gets to the scene of an accident and administers the GCS test, the person is awake, alert, and is often oriented to time, place, and person.  They can walk, respond to commands, and their eyes are open.  This is not at all unusual, even in patients who suffered a concussion in an accident.  And in those situations, the GCS score will always be 15. 

Does that mean the person did not have a concussion?  No, it does not.  It just means that, at the time the GCS test was administered, the person had a score of 15.  That is all.  Later on, when the person goes to the emergency room at the hospital, it is not uncommon for another GCS reading to be taken.  And, once again, it is to be expected that the score will be 15 in a mild traumatic brain injury patient.  And that is what it invariably is.  Importantly, the Glasgow Coma Scale is useless in ruling out the presence of a mild traumatic injury in a patient.

Traumatic Brain Injury Attorney Can Help You Today

Although the GCS is not useful in cases involving mild traumatic brain injury, defendants always point to the GCS reading of 15 as evidence of there having been no brain injury.  For that reason, a lawyer who represents traumatic brain injury survivors must be prepared to offer testimony from their own medical experts who can explain that the GCS does not rule out the presence of a mild traumatic brain injury, and to help the jury understand what the GCS is, and is not.

At The Mottley Law Firm, we know how a TBI can radically change your life and the impact it will have on your family and loved ones. We want to make sure victims are properly represented and have someone on their side to fight for their legal rights. Schedule a consultation with our traumatic brain injury attorneys in Richmond to let us know more about your specific situation. 

Kevin W. Mottley
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Richmond, VA trial lawyer dedicated to handling brain injuries, car accidents and other serious injury claims