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Spetzler–Martin grading scale

Grades surgical resection risk of a brain AVM by nidus size, area eloquence and venous drainage type.

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Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

Spetzler–Martin 1986: 3 factors, grade I–V; Spetzler–Ponce 2011 grouping A/B/C

A cerebral AVM classification focused on surgical risk. The local variant uses grades I–V and the Spetzler-Ponce A/B/C grouping; the original 1986 abstract also mentions a sixth group. Results from surgical series do not demonstrate equivalent performance for other treatment modalities.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Largest nidus diameter
Adjacent eloquent area (sensorimotor, language or visual cortex; hypothalamus, thalamus, internal capsule, brainstem, cerebellar peduncles or deep cerebellar nuclei)
Deep venous drainage (any component)

3/3 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

Size: < 3 cm = 1, 3 to 6 cm = 2, > 6 cm = 3 · Eloquent area = 1 · Deep venous drainage = 1. Grade is the sum (I to V).

Spetzler–Ponce (2011): class A = I and II; B = III; C = IV and V.

References

Identifier: spetzler-martin

Original clinical content: Brazilian Portuguese.

Method version

Spetzler–Martin 1986: 3 factors, grade I–V; Spetzler–Ponce 2011 grouping A/B/C

spetzler-martin@native-2026-10-03+8747632ddcfb

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (3)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Largest nidus diameter: < 3 cm
Adjacent eloquent area (sensorimotor, language or visual cortex; hypothalamus, thalamus, internal capsule, brainstem, cerebellar peduncles or deep cerebellar nuclei): No
Deep venous drainage (any component): No

{
  "tamanho": "1",
  "eloquente": false,
  "profunda": false
}

Expected result

{
  "score": 1,
  "level": "low",
  "verdict": "classe A"
}

Actual result

{
  "score": 1
}

Case 2

reference-002

Inputs

Largest nidus diameter: 3 to 6 cm
Adjacent eloquent area (sensorimotor, language or visual cortex; hypothalamus, thalamus, internal capsule, brainstem, cerebellar peduncles or deep cerebellar nuclei): Yes
Deep venous drainage (any component): No

{
  "tamanho": "2",
  "eloquente": true,
  "profunda": false
}

Expected result

{
  "score": 3,
  "level": "mid",
  "verdict": "classe B"
}

Actual result

{
  "score": 3
}

Case 3

reference-003

Inputs

Largest nidus diameter: > 6 cm
Adjacent eloquent area (sensorimotor, language or visual cortex; hypothalamus, thalamus, internal capsule, brainstem, cerebellar peduncles or deep cerebellar nuclei): Yes
Deep venous drainage (any component): Yes

{
  "tamanho": "3",
  "eloquente": true,
  "profunda": true
}

Expected result

{
  "score": 5,
  "level": "high",
  "verdict": "classe C"
}

Actual result

{
  "score": 5
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.