The Spetzler-Martin Grading Scale allocates points based on the anatomical features of the AVM. The grade is equal to the sum of the three scores (16). The higher the grade, the higher the risk of operative morbidity and mortality. These predictive data can then be discussed with the family to determine whether operative intervention is desirable.
| Factor | Measurement Parameter | Score |
| Size | 0-3 cm | 1 |
| >3 to 6 cm | 2 | |
| >6 cm | 3 | |
| Location | Noneloquent | 0 |
| Eloquent | 1 | |
| Deep venous drainage | Not present | 0 |
| Present | 1 |
A supplementary grading scale was developed in 2010; this scale considers patient age, hemorrhagic presentation, and compactness of the AVM nidus to formulate a score between 1 and 5 (97). This number is then added to the “original” Spetzler-Martin grade to yield a supplemented Spetzler-Martin grade between 2 and 10.
The supplemented Spetzler-Martin grade is a better predictor of the neurological outcome of AVM surgery than the Spetzler-Martin grade alone (98).
| Factor | Measurement Parameter | Score |
| Age | <20 years | 1 |
| 20-40 years | 2 | |
| >40 years | 3 | |
| Bleeding | Yes (ruptured) | 0 |
| No (unruptured) | 1 | |
| Compactness | Yes (compact) | 0 |
| No (diffuse) | 1 |
Spetzler-Martin-Supp grade (range: 2–10) = Spetzler-Martin grade (range: 1–5) + Supplementary grade (range: 1–5)
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