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Glasgow Coma Scale (with GCS-P)

Quantifies consciousness through eye opening, verbal and motor responses. GCS-P subtracts the pupillary reactivity score and extends prognostic information in traumatic brain injury.

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Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

GCS 3–15/Teasdale 1974; 2014 procedure; GCS-P/Brennan 2018: subtract pupillary score 0–2

Describe eye, verbal and motor responses as well as the total. GCS-P is the 2018 extension that subtracts pupil reactivity, studied in TBI cohorts. The score alone does not include all prognostic factors; assessments that are prevented or confounded require checking the edition’s instructions.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Eye opening (E)
Verbal response (V)
Best motor response (M)
Pupillary light reactivity

5/5 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

Glasgow = eye opening (1 to 4) + verbal response (1 to 5) + motor response (1 to 6), range 3 to 15.

GCS-P = Glasgow − pupillary reactivity score (0 = both react; 1 = one does not; 2 = neither reacts), range 1 to 15.

Standardized pressure stimulus (2014): nail-bed, trapezius or supraorbital-notch pressure.

References

Identifier: escala-de-coma-de-glasgow

Original clinical content: Brazilian Portuguese.

Method version

GCS 3–15/Teasdale 1974; 2014 procedure; GCS-P/Brennan 2018: subtract pupillary score 0–2

escala-de-coma-de-glasgow@native-2026-10-03+2f6ad53c6732

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (5)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Eye opening (E): 4 · Spontaneous
Verbal response (V): 5 · Oriented
Best motor response (M): 6 · Obeys commands
Pupillary light reactivity: Both react

{
  "o": "4",
  "v": "5",
  "m": "6",
  "p": "0"
}

Expected result

{
  "gcs": 15,
  "gcsp": 15
}

Actual result

{
  "gcs": 15,
  "score": 15,
  "gcsp": 15
}

Case 2

reference-002

Inputs

Eye opening (E): 3 · To sound
Verbal response (V): 4 · Confused
Best motor response (M): 5 · Localizing
Pupillary light reactivity: Both react

{
  "o": "3",
  "v": "4",
  "m": "5",
  "p": "0"
}

Expected result

{
  "gcs": 12,
  "gcsp": 12
}

Actual result

{
  "gcs": 12,
  "score": 12,
  "gcsp": 12
}

Case 3

reference-003

Inputs

Eye opening (E): 2 · To pressure
Verbal response (V): 2 · Sounds
Best motor response (M): 4 · Normal flexion
Pupillary light reactivity: One does not react

{
  "o": "2",
  "v": "2",
  "m": "4",
  "p": "1"
}

Expected result

{
  "gcs": 8,
  "gcsp": 7
}

Actual result

{
  "gcs": 8,
  "score": 8,
  "gcsp": 7
}

Case 4

reference-004

Inputs

Eye opening (E): 1 · Absent
Verbal response (V): 1 · Absent
Best motor response (M): 1 · Absent
Pupillary light reactivity: Neither reacts

{
  "o": "1",
  "v": "1",
  "m": "1",
  "p": "2"
}

Expected result

{
  "gcs": 3,
  "gcsp": 1
}

Actual result

{
  "gcs": 3,
  "score": 3,
  "gcsp": 1
}

Case 5

reference-005

Inputs

Eye opening (E): 2 · To pressure
Verbal response (V): NT · Not testable (e.g., intubated)
Best motor response (M): 5 · Localizing
Pupillary light reactivity: Both react

{
  "o": "2",
  "v": "nt",
  "m": "5",
  "p": "0"
}

Expected result

{
  "main": "E2 VNT M5",
  "level": "mid",
  "verdict": "não calculável"
}

Actual result

{
  "nt": 1
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.