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Case of the Month - September  2017

Patient with predominantly femoral right hemiparesis. Resonance and panangiography with findings consistent with a ruptured arteriovenous malformation. 

Patient underwent clipping and resection of the malformation through a frontoparietal craniotomy for an inter-hemispheric approach, with clipping and complete resection of the malformation. 

Spetzler-Martin Classification for Arveriovenous Malformations (AVMs)


  • AVM nest size

    • Small (<3cm) = 1

    • Medium (3-6cm) = 2

    • Large (> 6cm) = 3

  • Eloquent area of the brain?

    • Not eloquent  = 0

    • Eloquent = 1

  • Venous drainage

    • Only superficial  = 0

    • Deep = 1

Eloquence of the brain
Everything that controls the sensory or motor, language, visual cortex, thalamus, hypothalamus, brainstem, nuclei of the cerebellum, or the brain can be considered eloquent.  areas that are adjacent to them.




1. Spetzler RF, Martin NA. A proposed grading system for arteriovenous malformations. J. Neurosurg. 1986; 65 (4): 476-83.  doi: 10.3171 / jns.1986.65.4.0476  -  Pubmed citation

2. Iancu-Gontard D, Weill A, Guilbert F et-al. Inter- and intraobserver variability in the assessment of brain arteriovenous malformation angioarchitecture and endovascular treatment results. AJNR Am J Neuroradiol. 2007; 28 (3): 524-7.  AJNR Am J Neuroradiol (full text) 

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