Which ASA grade best describes a brain tumour with raised intracranial pressure?

Which ASA grade best describes a brain tumour with raised intracranial pressure?

• A. II or 2
• B. III or 3
• C. IV or 4
• D. V or 5

Answer: (C)

The concept being tested is how ASA grades reflect preoperative risk based on the severity of systemic disease. A brain tumour with raised intracranial pressure represents a life-threatening intracranial process; raised ICP can progress rapidly to brain herniation and loss of cerebral perfusion, making the patient’s condition a constant threat to life. This fits ASA IV, which describes severe systemic disease that is a constant threat to life. It’s more serious than ASA III, where the disease is significant but not consistently life-threatening, and not ASA V, which is moribund and not expected to survive without the operation. If the situation were an emergency, you’d note an emergency designation (IV E), but with these options, ASA IV is the best fit.

The concept being tested is how ASA grades reflect preoperative risk based on the severity of systemic disease. A brain tumour with raised intracranial pressure represents a life-threatening intracranial process; raised ICP can progress rapidly to brain herniation and loss of cerebral perfusion, making the patient’s condition a constant threat to life. This fits ASA IV, which describes severe systemic disease that is a constant threat to life. It’s more serious than ASA III, where the disease is significant but not consistently life-threatening, and not ASA V, which is moribund and not expected to survive without the operation. If the situation were an emergency, you’d note an emergency designation (IV E), but with these options, ASA IV is the best fit.