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Coma and Glasgow Coma Scale Eyes Glasgow Coma Scale Verbal Brain injuries are usually classified according to severity. They can be mild, moderate, or severe. When a brain injury occurs, two assessments are used to measure the severity: the Glasgow Coma Scale (GCS) and the Duration of Post- Traumatic Amnesia (PTA). Post-Traumatic Amnesia refers to the time between injury and the recovery of full memory for day-to-day events. The Glasgow Coma Scale is the most widely used scoring system for measuring the level of consciousness following traumatic brain injury. GCS has three parts: an assessment of eye opening, best motor response and best verbal response. 1 2 3 4 5 6 Does not Opens eyes in Opens eyes in Opens eyes open eyes response to painful N/A N/A response to voice spontaneously stimuli Makes no sounds Incomprehensible sounds Utters inappropriate words Confused, disoriented Oriented, converses normally N/A Motor Makes no movements Reaction to painful stimuli Abnormal flexion to painful stimuli Flexion / Withdrawal to painful stimuli Localizes painful stimuli Obeys commands A scoring system is used, with the lowest score being 3 and the highest 15. For example, a score of 8 or less would be regarded as a severe brain injury resulting in a coma state; a score of 9 to 12 would indicate a moderate brain injury; and a score of 13 to 15 would indicate a mild brain injury. 3 4 5 6 7 8 9 10 11 12 13 14 15 severe injury moderate injury mild injury 7
Post-Traumatic Amnesia (PTA) If you are in a coma as a result of a brain injury, afterwards you may have Post Traumatic Amnesia (PTA). Even mild concussion can cause a short period of Post Traumatic Amnesia. Someone emerging from a coma does not just wake up like in the movies, they go through a gradual process of regaining consciousness. This stage of recovery may last for hours, days or weeks. This may be a very confusing time for you. You may not have any idea of time, talking may be difficult and you may be very tired. Behavioural changes can also affect you. For example, some people become passive, or aggressive, abusive and agitated after being in a coma during the PTA stage. Some people liken PTA to being in a dream-like state. Some medical professionals believe that the duration of PTA is the best indicator of the severity of a brain injury. You will have little awareness of these behavioural and cognitive impairments and usually will remember nothing of what happened during PTA, even though you were fully awake. The good news is that PTA does not last for ever. Symptoms of Post-Traumatic Amnesia: No idea of time Talking may be difficult You may be tired Your behaviour may change - aggressive, abusive, agitated 8
Page 1 and 2: HEAD SPACE Brain Injury Handbook Cl
Page 3 and 4: Guide to the Handbook Introduction
Page 5 and 6: Chapter Contents 47 ............ Ch
Page 7: Effects of a Brain Injury The effec
Page 11 and 12: Types of Brain Injury Mild brain in
Page 13 and 14: Left and Right Brain The brain is d
Page 15 and 16: Frontal Lobe Damage COMMON EFFECTS
Page 17 and 18: Parietal Lobe Damage COMMON EFFECTS
Page 19 and 20: Cerebellum Damage COMMON EFFECTS OF
Page 21 and 22: Chapter Contents Fatigue and Tiredn
Page 23: Ways of coping Do your most demandi

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