Glasgow Coma Scale Score Assessment
For a patient who is confused, opens eyes to sound, and localizes to pain, the Glasgow Coma Scale (GCS) score is 11, which corresponds to a moderate traumatic brain injury (TBI).
GCS Score Calculation
The Glasgow Coma Scale evaluates three components:
Eye Opening (E):
- Opens eyes to sound = 3 points
Verbal Response (V):
- Confused = 4 points
Motor Response (M):
- Localizes to pain = 5 points
Total GCS Score = E + V + M = 3 + 4 + 5 = 11
Classification of TBI Severity Based on GCS
According to established guidelines 1, 2:
- Mild TBI: GCS 13-15
- Moderate TBI: GCS 9-12
- Severe TBI: GCS ≤8
With a GCS score of 11, this patient falls into the moderate TBI category.
Clinical Significance
A GCS score of 11 has important clinical implications:
- Patients with moderate TBI (GCS 9-12) have a higher risk of intracranial lesions requiring neurosurgical intervention compared to those with mild TBI 1
- A GCS score <14 is a criterion for transfer to a trauma center, as recommended by the National Expert Panel on Field Triage 2
- Serial GCS assessments are more valuable than a single determination for monitoring neurological status 2
Important Considerations
- The GCS was originally designed as a tool for serial evaluations by healthcare providers rather than as a single diagnostic measurement 1
- A single GCS score has limited prognostic value and is insufficient to determine the degree of parenchymal injury after trauma 1
- Some patients with the same GCS score but different patterns of component scores may have different clinical outcomes 3
Answer to Multiple Choice Question
The correct answer is: C. moderate
This patient's GCS score of 11 falls within the moderate TBI category (GCS 9-12) as defined by standard classification systems 1, 2.