GCS-Pupils Score
Combines the Glasgow Coma Scale with pupillary response to improve prediction of mortality and disability after traumatic brain injury. GCS-Pupils = GCS sum − Pupil Reactivity Score.
Score interpretation
GCS-Pupils 1–3 — critical brain injury. Mortality ~77% if score 1–3.
→ Immediate neurosurgery review; intubation and ventilation; ICP monitoring; CT head; early neurosurgical intervention if indicated
GCS-Pupils 4–8 — severe brain injury
→ Neurological intensive care; ICP management; CT head; neurosurgery review; neuroprotective measures
GCS-Pupils 9–12 — moderate brain injury
→ Inpatient monitoring; CT head; serial neurological assessments; neuro HDU
GCS-Pupils 13–15 — mild brain injury or normal
→ CT head per clinical pathway; observation period; discharge if criteria met
Interpretation bands for the GCS-Pupils. Apply clinical judgement and local guidance.
References
- Brennan PM et al. Simplifying the use of prognostic information in traumatic brain injury. Part 1: The GCS-Pupils score. J Neurosurg. 2018;128(6):1612–1620.
Related
Curated clinical cross-links plus same-class fallbacks.
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.