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Hideyuki Kano, Douglas Kondziolka, John C. Flickinger, Huai-che Yang, Thomas J. Flannery, Nasir R. Awan, Ajay Niranjan, Josef Novotny Jr. and L. Dade Lunsford

and 139 months after their initial procedure. Eighteen patients who underwent repeat SRS after prospective volume-staged SRS for a large nidus and 8 patients who were lost to follow-up were excluded, leaving 105 patients for evaluation. The series includes 53 males and 52 females. The median patient age was 31 years (range 2–66 years) at the initial SRS and 35 years (range 6–68 years) at repeat SRS. Eleven patients (10%) had undergone resection before their initial SRS. Thirty-four patients (32%) had undergone prior embolization before SRS. Sixty-five patients (62

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Hideyuki Kano, Douglas Kondziolka, John C. Flickinger, Huai-che Yang, Thomas J. Flannery, Nasir R. Awan, Ajay Niranjan, Josef Novotny Jr. and L. Dade Lunsford

follows: Score = (0.1) (volume in cm 3 ) + (0.02) (age in years) + (0.5) (location: basal ganglia, thalamus, or brainstem = 1, others = 0). Patients with a modified Pollock-Flickinger AVM score of 1.00 or lower had a higher rate of AVM obliteration without new deficits than patients with a Pollock-Flickinger AVM score greater than 2.00. The data were collected by 4 neurosurgeons (H.K., H.Y., T.F., and N.A.) who had not participated in patient management. The Spetzler-Martin grades were assigned by 2 experienced neurosurgeons (L.D.L. and D.K.) who had participated in

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Hideyuki Kano, L. Dade Lunsford, John C. Flickinger, Huai-che Yang, Thomas J. Flannery, Nasir R. Awan, Ajay Niranjan, Josef Novotny Jr. and Douglas Kondziolka

grading system was also used. 30 , 40 The equation used to calculate the modified Pollock-Flickinger AVM grading score is as follows: Score = (0.1) (volume in cm 3 ) + (0.02) (age in years) + (0.5) (location: basal ganglia, thalamus, or brainstem = 1, others = 0). T he modified Pollock-Flickinger AVM scores are shown in Table 1 . The data were collected by 4 neurosurgeons (H.K., H.Y., T.J.F., and N.R.A.) who had not participated in patient management. The Spetzler-Martin grades were decided by 2 experienced neurosurgeons (L.D.L. and D.K.) who had participated in