✓ An important factor in making a recommendation for treatment of a patient with arteriovenous malformation (AVM) is to estimate the risk of surgery for that patient. A simple, broadly applicable grading system that is designed to predict the risk of morbidity and mortality attending the operative treatment of specific AVM's is proposed. The lesion is graded on the basis of size, pattern of venous drainage, and neurological eloquence of adjacent brain. All AVM's fall into one of six grades. Grade I malformations are small, superficial, and located in non-eloquent cortex; Grade V lesions are large, deep, and situated in neurologically critical areas; and Grade VI lesions are essentially inoperable AVM's.
Retrospective application of this grading scheme to a series of surgically excised AVM's has demonstrated its correlation with the incidence of postoperative neurological complications. The application of a standardized grading scheme will enable a comparison of results between various clinical series and between different treatment techniques, and will assist in the process of management decision-making.
CelliP,,FerranteL,&PalmaL,et al:Cerebral arteriovenous malformations in children. Clinical features and outcome of treatment in children and in adults.Surg Neurol22:43–49,1984切利P,Ferrante L, Palma L, et al: Cerebral arteriovenous malformations in children. Clinical features and outcome of treatment in children and in adults.Surg Neurol 22:43–49, 1984
Celli
P
,
Ferrante
L
,
Palma
L
,
et al
:
Cerebral arteriovenous malformations in children. Clinical features and outcome of treatment in children and in adults.Surg Neurol
22
:
43
–
49
,
1984
切利P,Ferrante L, Palma L, et al: Cerebral arteriovenous malformations in children. Clinical features and outcome of treatment in children and in adults.
Surg Neurol 22:43–49, 1984
10.1016/0090-3019(84)90227-1)| false
DrakeCG:Cerebral arteriovenous malformations: considerations for and experience with surgical treatment in 166 cases.Clin Neurosurg26:145–208,1979Drake CG: Cerebral arteriovenous malformations: considerations for and experience with surgical treatment in 166 cases.Clin Neurosurg 26:145–208, 1979
ForsterDMC,,SteinerL,&HåkansonS:Arteriovenous malformations of the brain. A long-term clinical study.J Neurosurg37:562–570,1972Forster DMC, Steiner L, Håkanson S: Arteriovenous malformations of the brain. A long-term clinical study.J Neurosurg 37:562–570, 1972
FultsD,&KellyDLJr:Natural history of arteriovenous malformations of the brain: a clinical study.开云体育app官方网站下载入口15:658–662,1984Fults D, Kelly DL Jr: Natural history of arteriovenous malformations of the brain: a clinical study.Neurosurgery 15:658–662, 1984
Fults
D
,
Kelly
DL
Jr
:
Natural history of arteriovenous malformations of the brain: a clinical study.开云体育app官方网站下载入口
15
:
658
–
662
,
1984
Fults D, Kelly DL Jr: Natural history of arteriovenous malformations of the brain: a clinical study.
Neurosurgery 15:658–662, 1984
10.1227/00006123-198411000-00003)| false
GrafCJ,,PerretGE,&TornerJC:Bleeding from cerebral arteriovenous malformations as part of their natural history.J Neurosurg58:331–337,1983Graf CJ, Perret GE, Torner JC: Bleeding from cerebral arteriovenous malformations as part of their natural history.J Neurosurg 58:331–337, 1983
Graf
CJ
,
Perret
GE
,
Torner
JC
:
Bleeding from cerebral arteriovenous malformations as part of their natural history.J Neurosurg
58
:
331
–
337
,
1983
Graf CJ, Perret GE, Torner JC: Bleeding from cerebral arteriovenous malformations as part of their natural history.
J Neurosurg 58:331–337, 1983
10.3171/jns.1983.58.3.0331)| false
KjellbergRN,,HanamuraT,&DavisKR,et al:Bragg-peak proton-beam therapy for arteriovenous malformations of the brain.N Engl J Med309:269–274,1983Kjellberg RN, Hanamura T, Davis KR, et al: Bragg-peak proton-beam therapy for arteriovenous malformations of the brain.N Engl J Med 309:269–274, 1983
Kjellberg
RN
,
Hanamura
T
,
Davis
KR
,
et al
:
Bragg-peak proton-beam therapy for arteriovenous malformations of the brain.N Engl J Med
309
:
269
–
274
,
1983
Kjellberg RN, Hanamura T, Davis KR, et al: Bragg-peak proton-beam therapy for arteriovenous malformations of the brain.
N Engl J Med 309:269–274, 1983
10.1056/NEJM198308043090503)| false
LuessenhopAJ:Natural history of cerebral arteriovenous malformations, inWilsonCB,&SteinBM(eds):Intracranial Arteriovenous Malformations.Baltimore:Williams & Wilkins,1984, pp12–23Luessenhop AJ: Natural history of cerebral arteriovenous malformations, in Wilson CB, Stein BM (eds):Intracranial Arteriovenous Malformations.Baltimore: Williams & Wilkins, 1984, pp 12–23
Luessenhop
AJ
:
Natural history of cerebral arteriovenous malformations
, in
Wilson
CB
,
Stein
BM
(eds):Intracranial Arteriovenous Malformations.
Baltimore
:
Williams & Wilkins
,
1984
, pp
12
–
23
Luessenhop AJ: Natural history of cerebral arteriovenous malformations, in Wilson CB, Stein BM (eds):
Intracranial Arteriovenous Malformations.Baltimore: Williams & Wilkins, 1984, pp 12–23)| false
PellettieriL,,CarlssonCA,&GrevstenS,et al:Surgical versus conservative treatment of intracranial arteriovenous malformations. A study in surgical decision-making.Acta Neurochir Suppl29:1–86,1980Pellettieri L, Grevsten Carlsson CAS, et al: Surgical versus conservative treatment of intracranial arteriovenous malformations. A study in surgical decision-making.Acta Neurochir Suppl 29:1–86, 1980
Pellettieri
L
,
Carlsson
CA
,
Grevsten
S
,
et al
:
Surgical versus conservative treatment of intracranial arteriovenous malformations. A study in surgical decision-making.Acta Neurochir Suppl
29
:
1
–
86
,
1980
Pellettieri L, Grevsten Carlsson CAS, et al: Surgical versus conservative treatment of intracranial arteriovenous malformations. A study in surgical decision-making.
Acta Neurochir Suppl 29:1–86, 1980)| false
PerretG,&NishiokaH:Report on the Cooperative Study of Intracranial Aneurysms and Subarachnoid Hemorrhage. Section VI. Arteriovenous malformations. An analysis of 545 cases of cranio-cerebral arteriovenous malformations and fistulae reported to the Cooperative Study.J Neurosurg25:467–490,1966Perret G, Nishioka H: Report on the Cooperative Study of Intracranial Aneurysms and Subarachnoid Hemorrhage. Section VI. Arteriovenous malformations. An analysis of 545 cases of cranio-cerebral arteriovenous malformations and fistulae reported to the Cooperative Study.J Neurosurg 25:467–490, 1966
Perret
G
,
Nishioka
H
:
Report on the Cooperative Study of Intracranial Aneurysms and Subarachnoid Hemorrhage. Section VI. Arteriovenous malformations. An analysis of 545 cases of cranio-cerebral arteriovenous malformations and fistulae reported to the Cooperative Study.J Neurosurg
25
:
467
–
490
,
1966
Perret G, Nishioka H: Report on the Cooperative Study of Intracranial Aneurysms and Subarachnoid Hemorrhage. Section VI. Arteriovenous malformations. An analysis of 545 cases of cranio-cerebral arteriovenous malformations and fistulae reported to the Cooperative Study.
J Neurosurg 25:467–490, 1966
10.3171/jns.1966.25.4.0467)| false
SteinBM,&WolpertSM:Arteriovenous malformations of the brain. I. Current concepts and treatment.Arch Neurol37:1–5,1980Stein BM, Wolpert SM: Arteriovenous malformations of the brain. I. Current concepts and treatment.Arch Neurol 37:1–5, 1980
Stein
BM
,
Wolpert
SM
:
Arteriovenous malformations of the brain. I. Current concepts and treatment.Arch Neurol
37
:
1
–
5
,
1980
Stein BM, Wolpert SM: Arteriovenous malformations of the brain. I. Current concepts and treatment.
Arch Neurol 37:1–5, 1980
10.1001/archneur.1980.00500500031002)| false
SteinerL:Treatment of arteriovenous malformations by radiosurgery, inWilsonCB,&SteinBM(eds):Intracranial Arteriovenous Malformations.Baltimore:Williams & Wilkins,1984, pp295–314Steiner L: Treatment of arteriovenous malformations by radiosurgery, in Wilson CB, Stein BM (eds):Intracranial Arteriovenous Malformations.Baltimore: Williams & Wilkins, 1984, pp 295–314
Steiner
L
:
Treatment of arteriovenous malformations by radiosurgery
, in
Wilson
CB
,
Stein
BM
(eds):Intracranial Arteriovenous Malformations.
Baltimore
:
Williams & Wilkins
,
1984
, pp
295
–
314
Steiner L: Treatment of arteriovenous malformations by radiosurgery, in Wilson CB, Stein BM (eds):
Intracranial Arteriovenous Malformations.Baltimore: Williams & Wilkins, 1984, pp 295–314)| false
WilkinsRH:Natural history of intracranial vascular malformations: a review.开云体育app官方网站下载入口16:421–430,1985Wilkins RH: Natural history of intracranial vascular malformations: a review.Neurosurgery 16:421–430, 1985
