The first question doctors often get from families of brain injury survivors is, "How bad is it?"
Due to the complex and sometimes unpredictable nature of the brain, plus the often immediately unknown extent of the damage, that’s a hard question to answer. Luckily, medical science has developed incredibly extensive tests for brain damage, so it’s usually a matter of time before the doctors figure it out.
There are some critical measurements doctors rely on to give an early assessment of Traumatic Brain Injury (TBI) severity, no matter what type of TBI it is.
According to the National Institutes of Health, doctors often give initial brain damage assessments based on three primary factors:
- loss of consciousness,
- memory loss, and
- the Glasgow Coma Scale.
Let’s take a closer look at how doctors use all three together to form a first impression. We’ll start with the most involved test.
A Primary Indicator: The Glasgow Coma Scale (GCS)
According to a paper produced by the National Institutes of Health, the Glasgow Coma Scale (GCS) indicates the extent of impaired consciousness in a brain injury patient. Developed in 1974 by neurosurgery professors at the University of Glasgow in Scotland, this test assesses the ability to respond to stimulation in three basic ways: eye-opening, muscles (motor), and words (verbal). Each aspect is scored separately.
Normal scores are eye-opening 4, verbal 5, and motor 6, which totals 15. The lowest score is 1. Thus, the total coma score can be from 3-15, with 3 being the worst. Here’s a breakdown of each component from the paper, with the score to the left of the response:
Best Eye Response
- No eye-opening
- Eye-opening to pain
- Eye-opening to sound
- Eyes open spontaneously (normal)
Best Verbal Response
- No verbal response
- Incomprehensible sounds
- Inappropriate words
- Orientated (normal)
Best Motor Response
- No motor response
- Abnormal extension to pain
- Abnormal flexion to pain
- Withdrawal from pain
- Localizing pain
- Obeys commands (normal)
The score is often shown as the sum of its elements, which might look like this: GCS 10 = E3V4M3.
Now that you understand this, let’s look at how doctors use the scale to give an early assessment of the extent of brain damage.
These are also called concussions—but there’s nothing “mild” about them. A TBI is considered mild if:
- The person did not lose consciousness or was unconscious for less than 30 minutes.
- Memory loss lasted less than 24 hours.
- GCS was 13-15.
Medical science considers brain injuries moderate if:
- The patient was unconscious over 30 minutes, up to 24 hours.
- Memory loss lasted from 24 hours to 7 days.
- GCS was 9-12.
Brain injuries are deemed severe when:
- The patient was unconscious for over 24 hours.
- Memory loss lasted over 7 days.
- GCS was 8 or lower.
Once doctors determine the nature of the TBI, they can move quickly to the most important part—providing medical care to protect and heal the most critical organ in your body. A vital component of this can include ordering medical tests to get a more precise diagnosis.
If You’re an Accident Victim, Don’t Make Your Uphill Climb Steeper or Slicker
If you or a family member sustained a brain injury from an accident or work incident, you’ve got an uphill climb already, in just attempting to overcome brain damage. You can’t expect the at-fault party’s insurance company, or even your job’s workers' compensation insurance company if you got hurt at work, to be sympathetic or especially helpful. Relying on them like a doctor will only make your uphill battle steeper—or just pour an oil slick on top of it.
Just like you need a professional for medical care, you need a professional for your legal care—so you can focus on recovering as fully as possible.