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HOW EFFECTIVE IS THE GLASGOW COMA SCALE IN DIAGNOSING A TBI?

glasgow scaleDiagnosing effectively and accurately a traumatic brain injury remains today one of the most challenging tasks for neuroscientists all over the world.  Generally, diagnosis can be relatively easy when the brain injury is moderate or severe, since in this type of cases the signs and symptoms will be notorious.  However, that is not the case with mild traumatic brain injuries in which, in many cases, the signs are imperceptible and the symptoms may not appear for several days, weeks, or even months after the injury occurred.

When a person suffers a head trauma and is seeking medical attention, the most common procedure for emergency room personal and/or the treating physician is to conduct a standard history and physical evaluation.  In cases where the patient has experienced loss of consciousness, posttraumatic amnesia, or physical signs of skull fracture, other diagnostic tests and studies will be performed such as CAT and MRI scans.  There are other cases when only the Glasgow Coma Scale exam will be performed.  The questions become:  How Effective Is the Glasgow Coma Scale in Diagnosing TBI?  And how sensitive is this approach?

The Glasgow Coma Scale is the summation of scores for eye, verbal, and motor responses.  The minimum score is a 3, which indicates deep coma or brain-dead state.  The maximum score is 15, which indicates a fully awake patient.[1]  It is a common practice to classify the brain injury based on the results of the Glasgow Coma Scale as Severe with a score between 3 and 8, as Moderate with a score between 9 and 12, and Mild with a score between 13 and 15.

Even though this method of diagnosis can be effective when both the signs and symptoms are apparent, mainly in cases where the brain injury is moderate or severe, it has proven to be ineffective in hundreds if not thousands of mild traumatic brain injuries in which the symptoms and signs are not always apparent even for the most experienced medical professionals.  There have been an increasing number of reports stating that despite significant symptoms of brain injury, the patients were discharged after only receiving an analysis of the Glasgow Coma Scale, and in several other cases the symptoms even got worse.  No wonder why a University of Washington study revealed a 56% misdiagnosis rate of traumatic brain injuries in the emergency room setting.[2]  However, it is fair to think that the percentage of diagnosis of mild traumatic brain injuries is higher.

So, how effective is the Glasgow Coma Scale in diagnosing a TBI?  And how sensitive is this approach?  The Glasgow Coma Scale can be both effective and sensitive in cases where a person has sustained a moderate and severe brain injury, and both the signs and symptoms are apparent and/or visible.  The extent of the injuries, though, would have to be confirmed through other tests such as CAT and MRI scans, among others.  However, the Glasgow Coma Scale is not effective, sensitive nor 100% reliable in mild traumatic brain injury cases for the reasons previously stated.  Please read our blogs titled “New Technology in Diagnosing Traumatic Brain Injury,” and “Misdiagnosing a TBI Injury:  A Common Occurrence in the Emergency Room” for further information about this topic.

As attorneys who specialize in TBI cases, we understand the gravity of this type of injury, even if they are commonly labeled as “mild.”  Above all, we understand the devastating consequences that such injuries may cause.  For this reason, we will thoroughly analyze your particular situation from the cause of the injury, the type of tests and procedures performed to you by emergency room professionals and/or treating physicians, to the symptoms you are currently experiencing.  We feel true compassion for TBI victims and will do everything in our power you get fully compensated not only for your injury and damages, but for your pain and suffering as well.  Contact us today for a free evaluation of your case.

 

 

[1] https://www.openanesthesia.org/glasgow_coma_scale_definition/

[2] https://www.biodirection.com/about-tbi