A 57-year-old woman with history of breast cancer treated with L. mastectomy and chemotherapy and radiation presents with a 1- week history of headaches, gait instability, progressive confusion, and a new onset seizure. On physical examination she is somnolent and only opens her eyes in response to voice. She is only oriented to person (knows her own name) but is not oriented to place or date. She does not follow commands but does withdraw from painful stimuli. Emergent noncontrast head CT is performed, which reveals multiple masses with surrounding edema and no evidence of blood.
Based on the data provided what is the patient’s Glasgow Coma Score?A. 11
Correct Answer: A
The Glasgow Coma Scale provides a practical method for assessment of impairment of conscious level in response to defined stimuli. The scale measures the mental status of patients according to three categories of responsiveness: eye opening, motor, and verbal responses table below.
Glasgow Coma Scale Score:
The patient in this scenario opens her eyes to voice (3 points), withdraws from painful stimulus (4 points), and is confused and disoriented (4 points) and therefore has a Glasgow Coma Score of 11.