This study reviewed neurological assessment and therapeutic intervention records of adult, intubated, sedated and ventilated patients who had sustained a severe cerebral insult. The purpose of the study was to determine whether the Glasgow Coma Scale detected neurological change in the ventilated, sedated patient. In addition the study aimed to establish whether changes to therapeutic intervention took place in response to an alteration in Glasgow Coma Scale parameters. A retrospective analysis of patient observation records was conducted and descriptive statistics presented. The study found that the Glasgow Coma Scale did not predict or correlate with a sustained rise in intracranial perfusion pressure (ICP) in ventilated and sedated patients. Changes in therapeutic intervention appear to be initiated in response to changes in a number of differing parameters. It is suggested that it may not be appropriate to use the Glasgow Coma Scale as a neurological assessment tool in ventilated and sedated patients.