Types and Severity Levels of Brain Injury - Glasgow Coma Scale | Fieldfisher
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Levels of Brain Injury

Brain injury can take many forms. The types below show some of the most common.


A coma is a state of unconsciousness from which the individual cannot awake. You may have heard of the Glasgow Coma Scale. This rates the survivor’s ability to open his eyes and respond to verbal commands. The lowest possible score is 3, where there is in fact no response. An alert and oriented survivor will be rated at 15.

Open to verbal command
Open to pain
No response1

Best motor response to verbal command
Obeys verbal command

Best motor response to a painful command
Localised pain
Flexion - withdrawal
Flexion - abnormal
No response

Best verbal response
Oriented and converse
Disoriented and confused
Inappropriate words
Incomprehensible sound
No response

Vegetative State

This is a severe brain injury in which there is arousal but the ability to interact with the environment is not. There may be general response to pain and the eyes may open in response to stimulation.

Persistent Vegetative State

This term is used for someone who has been in a vegetative state for more than a month in their criteria is the same as above.

Minimal Responses State

This term is used for those who have suffered severe traumatic brain injury and may have come out of a coma or a vegetative state.

They will have primitive reflexes but will not be able to necessarily follow simple commands. They will have an awareness of environmental stimulation.

Moderate Traumatic Brain Injury

Here the Glasgow Coma Scale will be between 9 and 12. There will be:

  1. A loss of consciousness for more than a few minutes to a few hours;
  2. Confusion lasting at least a matter of weeks; and
  3. Cognitive and behavioural impairments which may be permanent.

Treatment is imperative in moderate traumatic brain injury as the individual may have to relearn the most basic of communication skills and self caring.

Mild Brain Injury

Whilst a severe traumatic injury is obvious to all, a mild brain injury may go undetected and unrecognised.

The individual may have suffered:

  • brief loss of consciousness; and
  • loss of memory of events immediately following the incident in which they were involved.

The injury may not be obvious on an MRI scan and some survivors themselves may not be aware of the symptoms of their injury. However, many people with a mild injury realise that there is something wrong but do not understand what. They may face difficulty in obtaining treatment.

When faced with such difficulties in the course of a personal injury claim, we would seek the advice of an appropriately qualified Specialist such as a Neuro Psychologist to conduct psychometric tests to evaluate the extent of the injury and the effects on the individual.

Whilst a brain injury in medical terms may be described as mild, the effect on the individual can be devastating.

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