People can easily understand that there are chances of memory getting affected after a traumatic brain injury. But what they do not realize is that such injuries can also affect your emotions. Emotions are not something that float in the air and conveniently and occasionally plants itself in your head. They reside within the head, as do many things.

Two common changes that impact a person after a head injury are increased levels and sudden bursts of anger and depression. The affected person gets angry fast and the intensity of his anger can reach dangerous proportions bringing harm to those around him. Post-head injury anger is different in a way that it triggers as fast as it subsides. You tend to get angry with the smallest provocation and even when the situation has turned to normal, you continue to remain in a ‘bad mood’ for the rest of the day. It is also not uncommon to find people after a head injury bursting into tears for trivial reasons.

The unfortunate part of the story is that when a person suffers such emotional changes, many friends and families do not understand that this is the result of a physical injury to the brain.  They often do not realize that this was caused by damage to the brain and not just being overly emotional. Quite often the brain injury patient is incredibly frustrated by the inability to do things and live independently like before the accident and feelings of helplessness further foster these emotional changes.

For these reasons, it is often necessary for the patient to not only treat with a psychologist but to be involved in group counseling to share  and discuss their issues with other victims.  Many times, it is even helpful for the brain injury victim to attend therapy and counseling sessions with family members so they can better understand what has happened and how to deal with anger and depression issues.

Assessing the state of consciousness of a patient who has suffered traumatic brain injury is often done by emergency medical responders and physicians shortly after an accident.  The Glasgow Coma Scale (GCS) assists a medical team to have an objective assessment of the extent of consciousness of the victim. The scale helps the team to conclude the degree to which the patient is conscious or comatose.

The Glasgow Coma Scale (GCS) is also known by another name – Glasgow Coma Score. The scale uses a rating method ranging from 3 to 15, where the higher level of consciousness is denoted by a higher score. An example can explain this better. A healthy conscious adult would have a score of 15 but a completely unconscious individual would get a score of 3.

To assess the medical condition of a patient who has suffered a traumatic brain injury in the immediate past, the Glasgow Coma Scale (GCS) provides invaluable help to doctors and emergency room staff. Of course the scale is also frequently used by other streams of the medical fraternity including doctors attached to intensive care units, EMTs and healthcare providers responsible for chronic care.

Glascow Coma Scale – how did it begin?

It took two professors of neurosurgery, Graham Teasdale and Bryan J. Jennett, teaching at the University of Glasgow to come up with the Glasgow Coma Scale (GCS) in 1974. With years of experience in the field of management of head trauma and brain injuries, the duo even published a book called Management of Head Injuries in 1981.

Teasdale and Jennett’s untiring work on the subject has helped millions of doctors round the world to successfully diagnose and treat comatose patients who have been victims of head trauma and brain injuries. Their work has also provided inspiration and motivation to other researchers and doctors to design similar diagnostic tools, especially the Rancho Los Amigos Scale. This scale is one of the most efficient tools to assess traumatic brain injuries or TBI.

Glascow Coma Scasle – how it does what it does

The state of consciousness of a brain-injured patient is assessed by the GCS using a 15-point rating method as mentioned earlier. The scale works by allotting points to the several physical responses received from the victim. These include evaluating his sense of vision, verbal responses and other motor skills. The table below shows how the point allotment is done by the GCS.

Physical Response

To clear any ambiguity in the assessment of level of consciousness between children and adults, since both can suffer from the same condition of loss of consciousness, the GCS has included a special feature for examining the verbal ability of the patient. The verbal ability of the respondent is then adjusted in the point rating according to categories as mentioned below:

• 1 point: Zero response or silent
• 2 points: Groans or snorts
• 3 points: Continuous crying. Babies would cry even with positive stimuli
• 4 points: Incoherent murmuring. Babies cry at the right time and responds well when comforted.
• 5 points: No speech impairment. Infants smile and blabber.

Though allocating points to the different consciousness levels and relating it to the correct condition may seem easy, the job of categorizing the patients may not be as simple. For example, when the eyes are inflamed after a traumatic head injury, doctors find it difficult to assess the visual responses of the patient.

Therefore doctors might have to use the GCS several times on a patient with head trauma and brain injuries to decipher the precise condition of the individual and also to identify the emerging needs.