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Traumatic Brain Injury Information

Glasgow Coma Scale

What is a TBI?

Traumatic Brain Injuries (TBIs) are injuries caused by a blow or injury to the head -- commonly from falls, vehicle collisions, or blunt trauma -- and result in damage to the brain.  TBIs are often associated with memory issues, light/noise sensitivity, nausea, headaches, and difficulty concentrating. The severity of TBIs can vary greatly. TBIs can also impact social communication and discourse abilities in the long-term, which in turn affect employment, social relationships, and quality of life. However, they can be treated with therapy: physical therapy (regaining balance and movement), speech therapy (regaining memory and language), or neuropsychological therapy (navigating symptoms). In general, "brain rest" is recommended for all forms of recovery and includes limiting screen time and intense cognitive workload.

Eye Opening

Testing reflux responses to pressure

  • 4: Eyes open before stimulus (spontaneous)

  • 3: Eyes open after spoken or shouted request (to sound)

  • 2: Eyes open after finger tip stimulus, trapezius pinch, supraorbital notch (to pressure)

  • 1: No opening at any time, no interfering factor (none) 

  • Non-testable (NT): Eyes closed by local factor

Verbal Response

Asking questions that test memory, thinking ability and awareness of the environment

  • 5: Correctly gives name, place, and date (orientated) 

  • 4: Not orientated but coherent communication (confused) 

  • 3: Intelligible single words (words) 

  • 2: Only moans or groans (sounds) 

  • 1: No audible response, no interfering factor (none) 

  • NT: Other factor interferes with communication

Motor Response

Testing the connections between your nerves, spinal cord and brain

Testing the brain's ability to control muscle movement and follow directions

  • 6: Obey 2-part command (obeys commands)

  • 5: Stimulus on head neck, bringing hand above the clavicle (localising)

  • 4: Bends arm at elbow rapidly (normal flexion)

  • 3: Bends arm at elbow (abnormal flexion)

  • 2: Extends arm at elbow (extension)

  • 1: No movement, no interfering factor (none)

  • NT: Other factors interferes with motor response (eg. paralysis)

Conclusion

Mild TBI (GCS 13-15)

  • The person should receive rest or simple over-the-counter medications

  • E.g. Acetaminophen for treating headaches resulting from TBI

  • Limit exposure to screens, and make sure the individual gets cognitive and physical rest

  • A caregiver should monitor the person closely to observe any changes in health status or symptoms

  • If there is an increase in symptoms, schedule an appointment or follow up with a doctor

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​​Moderate TBI (GCS 9-12) and Severe (GCS 3-8)

  • Call 911 immediately or reach out to emergency services at your local hospital

  • Unless completely necessary, do not change the position of the person and keep their head and spinal cord stable until emergency services arrive

  • Make sure the person has sufficient oxygen and proper blood circulation, maintaining stable blood pressure and preventing any additional harm to the head or neck

  • If there is bleeding, firmly press a clean cloth on the wound, unless a skull fracture is suspected

  • Medical professionals will give a CT scan (a noninvasive imaging procedure which will take X-rays of the body)

  • The immediate emergency care will most likely be followed by rehabilitation therapy

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