====== Cerebral Arteriovenous Malformation Grading ======

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[[Screening]] of 865 [[paper]]s revealed thirteen [[grading]] systems 
((Davies JM, Kim H, Young WL, Lawton MT. Classification schemes for arteriovenous malformations. Neurosurg Clin N Am. 2012;23(1):43–53.))
((Griessenauer CJ, Miller JH, Agee BS, et al.. Observer reliability of arteriovenous malformations grading scales using current imaging modalities. J Neurosurgery. 2014;120(5):1179–1187.))
((Hollerhage HG, Dewenter KM, Dietz H. Grading of supratentorial arteriovenous malformations on the basis of multivariate analysis of prognostic factors. Acta Neurochir (Wien). 1992;117(3-4):129–134.))
((Pertuiset B, Ancri D, Kinuta Y, et al.. Classification of supratentorial arteriovenous malformations: a score system for evaluation of operability and surgical strategy based on an analysis of 66 cases. Acta Neurochir (Wien). 1991;110(1-2):6–16.))
((Spears J, Terbrugge KG, Moosavian M, et al.. A discriminative prediction model of neurological outcome for patients undergoing surgery of brain arteriovenous malformations. Stroke. 2006;37(6):1457–1464.))
((Tamaki N, Ehara K, Lin TK, et al.. Cerebral arteriovenous malformations: factors influencing the surgical difficulty and outcome. Neurosurgery. 1991;29(6):856–861; discussion 861-863.)).
for [[cerebral arteriovenous malformation]] microsurgical risk stratification. Among them, two systems were specifically developed for [[ruptured cerebral arteriovenous malformation]] and one specifically for [[posterior fossa arteriovenous malformation]]. With one system being fundamentally different for supratentorial bAVM, the remaining nine systems used the same parameters: "size," "eloquence," "venous drainage," "arterial feeders," "age," "nidus compactness," and "hemorrhagic presentation". This study provides a comprehensive overview of all available bAVM grading systems relevant for surgical risk stratification. Furthermore, in the absence of a universal system appropriate to score all bAVMs, a workflow for selection of the best applicable scoring system in accordance with bAVM subgroups is presented
((Grüter BE, Sun W, Fierstra J, Regli L, Germans MR. Systematic review of brain arteriovenous malformation grading systems evaluating microsurgical treatment recommendation. Neurosurg Rev. 2021 Jan 27. doi: 10.1007/s10143-020-01464-3. Epub ahead of print. PMID: 33501562.)).
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The first major [[Cerebral Arteriovenous Malformation Grading]] scheme developed by Luessenhop and Gennarelli in [[1977]]
((Luessenhop AJ, Gennarelli TA. Anatomical grading
of [[supratentorial arteriovenous malformation]]s for
determining operability. Neurosurgery 1977;1(1):
30–5.)) 
formulated a grade from I to IV based on the number of feeding arteries for which it is standardized nomenclature
((Davies JM, Kim H, Young WL, Lawton MT. Classification schemes for arteriovenous malformations. Neurosurg Clin N Am. 2012;23(1):43–53.))
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Luessenhop and Rosa
((Luessenhop AJ, Rosa L. Cerebral arteriovenous
malformations. Indications for and results of surgery,
and the role of intravascular techniques. J Neurosurg 1984;60(1):14–22))
simplified this grading scheme in [[1984]] by considering only the angiographic size of the [[AVM]], which was believed to be easier than counting arterial feeders. 
The new grades were assigned based on nidus diameter: grade I, less than 2 cm; grade II, 2 to 4 cm; grade III, 4 to 6 cm; and grade IV, greater than 6 cm. The original classification scheme excluded AVMs in the cerebellum, brain stem, and region of the vein of Galen malformations, whereas the new scheme included [[cerebellar arteriovenous malformation]]s
((Davies JM, Kim H, Young WL, Lawton MT. Classification schemes for arteriovenous malformations. Neurosurg Clin N Am. 2012;23(1):43–53.)) 

===== Spetzler-Martin AVM grading system =====

The [[Spetzler-Martin AVM grading system]] is the most widely used grading system for AVMs.

===== Supplementary Spetzler-Martin AVM grading scale =====

see also [[Supplementary Spetzler-Martin AVM grading scale]].

===== Spetzler Ponce classification =====


see [[Spetzler Ponce classification]].

===== References =====