Wells Adam James, Reilly Peter Lawrence
Department of Neurosurgery, Royal Adelaide Hospital, South Australia, Australia; Department of Surgery, The University of Adelaide, Australia.
Faculty of Health and Medical Sciences, The University of Adelaide, Australia.
J Clin Neurosci. 2025 Mar;133:110994. doi: 10.1016/j.jocn.2024.110994. Epub 2025 Jan 5.
The Glasgow Coma Scale (GCS) was first published in The Lancet by Sir Graham Teasdale and Bryan Jennett 50 years ago based on their pioneering work on developing a numerical scale to describe coma in clear and reproducible terms and to avoid the confusion associated with the wide variety of descriptive terms for consciousness that were in use at the time. It's difficult to know if Teasdale and Jennett could have predicted how influential, widespread and long-lasting the GCS would become, but in retrospect it seems clear that the GCS was introduced at a perfect stage in the development of modern clinical neurosurgery and neuroscience research. The simplicity of the scale, its recognition by senior academics and the emerging radiology technologies in the 1970s heralded a new era of neuroscience and an approach to the management of not only traumatic brain injury (TBI) but other types of central nervous system disease in which consciousness was affected, such as aneurysmal subarachnoid haemorrhage and stroke. Together with its sister scale the Glasgow Outcome Scale, the GCS remains extremely relevant in clinical neurosurgery and neuroscience research, and despite the proposal of various alternative scales the GCS endures in the modern management of TBI.
50年前，格雷厄姆·泰斯代尔爵士和布莱恩·詹尼特在《柳叶刀》杂志上首次发表了格拉斯哥昏迷量表（GCS）。该量表基于他们开创性的工作，旨在开发一种数字量表，以清晰、可重复的方式描述昏迷，并避免当时使用的各种意识描述术语所带来的混淆。很难说泰斯代尔和詹尼特是否能预测到GCS会变得如此有影响力、广泛应用且持久，但回顾起来，很明显GCS是在现代临床神经外科和神经科学研究发展的一个完美阶段被引入的。该量表的简单性、得到资深学者的认可以及20世纪70年代新兴的放射学技术，预示着神经科学的一个新时代，以及一种不仅适用于创伤性脑损伤（TBI），还适用于其他意识受影响的中枢神经系统疾病（如动脉瘤性蛛网膜下腔出血和中风）的管理方法。与它的姊妹量表格拉斯哥预后量表一起，GCS在临床神经外科和神经科学研究中仍然极其重要，尽管有人提出了各种替代量表，但GCS在TBI的现代管理中依然存在。
