Assessment of Glasgow Coma Scale


About GCS

The assessment of Glasgow Coma Scale is of paramount importance in managing patients with Neurosurgical pathology. Note is not an assessment of pure neurological function but rather as a global assessment of consciousness.

Breakdown of GCS

GCS can be broken down into three elements:

Eye Movements:

  1. Opens eyes spontaneously
  2. Opens eyes to voice
  3. Opens eyes to pain (Test via applying pressure over the supra-orbital notch)
  4. None


  1. Orientated
  2. Confused
  3. Inappropriate Words
  4. Incomprehensible Sounds
  5. None


  1. Obeys Commands
  2. Localises
  3. Withdraws
  4. Flexes (decorticate posturing)
  5. Extends (decerebrate posturing)
  6. None


Importance of GCS

  1. Identifying the trend
  2. Not all patients with a drop in their GCS is intra-cranial!
  3. See assessment of consciousness lecture