Buffalo Score of Dumont et al for Grading Endovascular Treatment of a Cerebral Arteriovenous Malformation

Description

Dumont et al proposed a grading system for a cerebral arteriovenous malformation. This correlates with outcome after endovascular treatment. The authors are from the University of Buffalo, Kaleida Health, Jacobs Institute, University of Arizona and University of South Florida.

Patient selection: cerebral arteriovenous malformation

Parameters:

(1) number of arterial pedicles

(2) diameter of arterial pedicles in mm

(3) eloquence at nidus location

Parameter	Finding	Points
number of arterial pedicles	1 or 2	1
	3 or 4	2
	>= 5	3
diameter of arterial pedicles	most > 1 mm	0
	most <= 1 mm	1
nidus location	noneloquent	0
	eloquent	1

where:

• Eloquent: motor or sensory cortex including language and vision; hypothalamus; thalamus; brainstem; cerebellar peduncles

grade =

= SUM(points for all 3 parameters)

Interpretation:

• minimum grade: 1

• maximum grade: 5

• The risk of complications after endovascular embolization increases with the grade.

Grade	Overall Complication Rate
I	0%
II	0%
III	14%
IV	50%
V	75%

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