The Publishing House Medicine of the Romanianacademy

The anatomic diversity of the cerebellar arteriovenous malformations requires a classification which is more surgically informative. The selection tools like the Spetzler-Martin grading system are best suited for the cerebral arteriovenous malformations, while they are quite inaccurate for the cerebellar AVMs. For this reason, in order to define the subtypes of cerebellar arteriovenous malformations that clarify the anatomy and the surgical management, Kim et al. (2015) had validated a supplementary grading system for the improvement of the preoperative risk prediction and for a more adequate selection of the patients for surgery. The predictive accuracy of the supplementary grading system had been superior to that of the Spetzler-Martin grading for the cerebellar arteriovenous malformations. The predictive accuracy of the supplementary system had been consistent for both the cerebral and the cerebellar arteriovenous malformations. It had also been proven that the supplementary grading system is better than the Spetzler-Martin system for the prediction of the outcomes after the resection of a cerebellar arteriovenous malformation. In a consecutive surgical series of 367 patients, 28 (7.62%) had cerebellar arteriovenous malformations. The subtypes of the cerebellar arteriovenous malformations had been as follows: hemispheric 9 (32.14%); vermian 7 (25%); tentorial 4 (14.28%); tonsillar 3 (10.71%), suboccipital 3 (10.71%); of the cerebellopontine angle 2 (7.14%). The patients with cerebellar arteriovenous malformations had presented more often with hemorrhage than the patients with cerebral AVMs, reason which justifies the use of a more aggressive treatment. The postoperative evolution of the 28 patients with cerebellar arteriovenous malformations had been very good and good, without being registered any important neurological deficits. The evolution of the patients with tonsillar and tentorial arteriovenous malformations had been the most favorable.