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The Glasgow Coma Scale (GCS) is a well-known, universally applied scale (Table 84.2).40 It relies on inde- pendent assessment of eye opening, speech, and best motor movement in response to progressive trials of command, voice, and noxious stimuli.
The World Federation of Neurologic Surgeons (WFNS) scale is the pre- ferred rating because it uses the more prevalent GCS but with a modifying component for focal deficit (Table 84.3).
TABLE 84.2 Glasgow Coma Scale for Head Injury
GCS, Glasgow Coma Scale.
Penetrating injury may again have widely varying consequences depending on site, depth, and energy, but is generally fatal if it bilaterally traverses the midbrain.112 The GCS categorizes TBI into mild, moder- ate, and severe injury according to the patient's present- ing clinical characteristics and correlates with outcome after TBI (see Table 84.2).113 Additionally, the Abbrevi- ated Injury Scale (AIS) score for the head and neck region classifies TBI by ranking injuries on a six-point scale based on mortality risk, with "1" indicating minor injury and "6" indicating a nonsurvivable injury.
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