Measuring a brain injury: The Glasgow Coma Scale (GCS) is the most common scoring system used to describe the level of consciousness in a person following a traumatic brain injury. In basic terms it is used to help gauge the possible severity of an acute brain injury, particularly in the early stages post trauma.
GCS is tested via a simple objective test and measures the following 3 functions:
Eye Opening (E) / Verbal Response (V) / Motor Response (M)
For each of the functions above, a scoring system between 1 and 6, depending on the response being measured, is utilised by a trained professional and the combined score of these responses leads to a classification of:
It should be noted however that there are limitations to the GCS whereby factors such as drug use, alcohol intoxication, shock, or low blood oxygen can alter a person’s level of consciousness and these factors could lead to an inaccurate score being recorded.
The GCS is also not usually used with younger children, especially those too young to have reliable language skills. In this instance the Paediatric Glasgow Coma Scale ( PGCS) a modification of the scale used on adults, can be used instead. The PGCS still uses the three tests — eye, verbal, and motor responses but with this test the three values are considered separately as well as together.
Effects of brain injury
Every person's injury is unique, so they may experience any number of the symptoms which can range from mild to severe. Some of the most common effects of brain injury are listed below.
Post-traumatic amnesia is the time after a period of unconsciousness when the injured person is conscious and awake, but is behaving or talking in a peculiar or uncharacteristic manner.
Coma and reduced awareness states
Whether it lasts for a few seconds or a few weeks, the usual immediate effect of brain injury is a loss of consciousness.
Cognitive effects of brain injury
Different mental abilities are located in different parts of the brain, so a head injury can damage some, but not necessarily all. Skills which are frequently impacted include speed of thought, memory, understanding, concentration, problem solving and language ability.
Communication problems after brain injury
Communication problems after brain injury are very common as the ability to communicate requires extremely complex skills and employs many different parts of the brain.
Emotional and behavioural effects of brain injury
Anyone who has experienced a head injury can be left with some changes in emotional reaction and behaviour. These changes are often the most difficult for the individual and their family to deal with.
Rehabilitation and continuing care after brain injury
Unlike most other cells in the body, brain cells do not regenerate when they are destroyed. However, this does not mean that no recovery can occur. The brain is somewhat flexible and is able to reorganize itself, to an extent, in order to regain lost function.
In the first month or two after a severe brain injury it is only possible to guess at the length of time that recovery will take and the likely outcome. All that is certain is that recovery is a slow process and will take months or years rather than weeks.
It is suggested that there is a limited window for recovery after brain injury, for example, that recovery ceases to take place beyond two years. However, recent research has shown this not to be the case and people may actually continue to improve for a number of years after brain injury.
Nevertheless, the greatest visible progress does occur in the first six months post-injury and after this improvement is often less obvious.