Microsurgery for Spetzler-Martin Grade I–III Arteriovenous Malformations: Analysis of Surgical Results and Correlation of Lawton-Young Supplementary Grade and Supplemented Spetzler-Martin Score with Functional Outcome

Residual brain AVMs after surgical resection: A literature review of causes and treatment considerations

“…AVMs in eloquent areas of the brain, such as the motor, language and visual areas as well as deep structures, present a challenge as they are associated with increased morbidity. 25 While our data showed that most residual AVMs occurred in a non-eloquent area of the brain (57.8%), data from Englot et al found that AVMs occurred more frequently in eloquent areas of the brain (60.3%) when compared to non-eloquent areas (39.7%). 21 On the other hand, the percentage of AVMs that were positive versus negative for eloquence was found to be equal in the study by Chowdhury et al 22 One would expect that location in an eloquent area of the brain would warrant higher level of caution during resection to preserve healthy tissue, and would hence lead to a higher potential of residual AVM from occurring.…”

“…A higher grade is predictive of increased rate of morbidity post-surgery and greater prospective risk of hemorrhage. 25 , 26 Given the lower operative risk with grade 1 and 2 AVMs, surgical resection is the treatment of choice. 27 For grade 3 to 5 AVMs, multiple treatment options are available in addition to surgery, including embolization and stereotactic radiosurgery.…”

Cerebral Arteriovenous Malformation Deep Draining Veins Not Observed on Preoperative Angiography Identified on Postoperative Angiography

“…The presence of an AVM represents a significant risk of morbidity and mortality from intracranial hemorrhage, conferring a 2-4% annual risk of hemorrhage. If a hemorrhage has occurred, there is a 17-90% lifetime risk of rehemorrhage [1,[7][8][9][10].…”

“…The S-M grading scale considers the size, venous drainage, and eloquence of the involved brain region to give a numerical value between 1 and 5; it is the most commonly used grading system to assess surgical risk [ 9 , 11 ]. These grades are useful for directing treatment because a higher grade correlates with a greater risk of major deficit postresection and a lower grade correlates to a greater risk of hemorrhage [ 2 , 4 , 8 , 12 , 13 ].…”