Head Injury (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Head injury facts
- Head injury introduction
- What are the causes of head injury?
- What are the symptoms of a head injury?
- What is the Glasgow Coma Scale?
- When should I contact a doctor about a head injury?
- How is a head injury diagnosed?
- How is a head injury treated?
- What is the prognosis for a head injury?
- How can a head injury be prevented?
- What about a head injury in infants and young children?
- Find a local Doctor in your town
What is the Glasgow Coma Scale?
The Glasgow Coma Scale was developed to provide health care practitioners a simple way of measuring the depth of coma based upon observations of eye opening, speech, and movement. Patients in the deepest level of coma:
- do not respond with any body movement to pain,
- do not have any speech, and
- do not open their eyes.
Those in lighter comas may offer some response, to the point they may even seem awake, yet meet the criteria of coma because they do not respond to their environment.
|To loud voice||3|
|Withdraws from pain||4|
|Abnormal flexion posturing||3|
An awake person has a Glasgow Coma Scale of 15, while a person who is dead would have a score of 3. The abnormal motor responses of flexion and extension describe arm and leg movement when a painful stimulus is applied. The term "decorticate" means that the cortex of the brain, the part that deals with movement, sensation, and thinking, is not working. "Decerebrate" means that the cerebrum (the whole brain), the cortex, and the brainstem that controls basic bodily functions like breathing and heartbeat, is not working.
The scale is used as part of the initial evaluation of a patient, but does not assist in making the diagnosis as to the cause of coma. Since it "scores" the level of coma, the Glasgow Coma Scale can be used as a standard method for pre-hospital emergency providers to determine the severity of head injury. It also allows the next provider in the chain of care to compare their assessment to the previous one. In this way, there is a standard score to determine whether the patient is improving or decompensating from the injury scene during the transitions to the ER, to the operating room, or ICU.
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