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Glasgow
Coma Scale
and
the Causes of Coma
The Glasgow Coma Scale (GCS) is used to assess consciousness
levels. The minimum score is 3 (deep unconsciousness), the
maximum is 15 (full consciousness).
Test
Type |
SCORE |
1 |
2 |
3 |
4 |
5 |
6 |
Eye |
Closed |
Open
to pain |
Open
to voice |
Open
spontaneously |
- |
|
Motor Response |
No movement |
Displays
extension |
Displays
flexion |
Displays
withdrawal from pain |
Localises pain |
Voluntary |
Vocal
Response |
None |
Groans |
Inappropriate
words |
Disorientated
speech |
Orientated speech |
|
Causes
of Coma |
Cerebral
|
·
Intracranial haemorrhage
· Large cerebral infarct
· Pontine haemorrhage (pinpoint pupils)
· Cerebral venous sinus thrombosis
· Hypertensive encephalopathy
· Cerebral tumour
· Head injury
· Cerebral infection—encephalitis, meningitis,
cerebral malaria, brain abscess
· Post-ictal state
· Sub-clinical status epilepticus
· Cerebral vasculitis
· End-stage multiple sclerosis
· Leucodystrophy
· Creutzfeldt-Jakob disease |
Metabolic
|
·
Drugs
· Alcohol excess
· Hypoglycaemia
· Diabetic ketoacidosis
· Hyperosmolar non-ketotic coma
· Uraemia
· Late stages of hepatic encephalopathy
· Severe hyponatraemia
· Hypothyroidism
· Hypercalcaemia
· Inborn error of metabolism
· Type 2 respiratory failure
· Severe hypothermia
· Hyperpyrexia
· Severe nutritional deficiency
|
 |
Sources
Provan, D. and A. Krentz. Oxford Handbook of Clinical
and Laboratory Investigation. Oxford, etc.: Oxford University
Press, 2002. |
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