Glasgow Coma Scale

First introduced in 1974 at the University of Glasgow by neurosurgery professors Graham Teasdale and Bryan Jennett, the Glasgow Coma Scale (GCS) offers an objective method for describing the extent of impaired consciousness in patients with acute medical conditions or trauma. The scale evaluates 3 aspects of responsiveness—eye-opening, verbal, and motor responses. Reporting each component separately allows clinicians to communicate a clear and detailed picture of the patient’s neurologic status. Individual findings from each component may also be aggregated into a total Glasgow Coma Score, offering a concise, though less detailed, summary of overall severity. For example, a score of 10 may be documented as GCS10=E3V4M3, indicating the specific values for each response category. The widespread adoption of the GCS began in the 1980s, following the endorsement of its use for trauma patients in the first edition of the Advanced Trauma and Life Support (ATLS) course. In 1988, the World Federation of Neurosurgical Societies (WFNS) incorporated it into its grading scale for subarachnoid hemorrhage. The GCS has since become embedded in numerous clinical guidelines and scoring systems for trauma and critical illness, extending across all age groups, including preverbal children. Required by the NIH Common Data Elements for head injury studies and included in the ICD-11, the GCS is now used in over 75 countries. Since 1974, publications referencing the GCS have increased globally at an average annual rate of 16.7%, accumulating over 37,000 citations.