Pollock-Flickinger Score (AVM Radiosurgery Outcome)

The POLLOCK-FLICKINGER RADIOSURGERY-BASED AVM SCORE (2002, modified 2008) predicts the outcome of STEREOTACTIC RADIOSURGERY for a brain arteriovenous malformation.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

AVM volume
8 cm^3
Patient age
40 years
Anatomical site
Basal ganglia

Result: 1.9

The tool opens with these values already filled in. Replace them with your own.

What the result means

Original tiers
0 frontal/temporal; 1 parietal, occipital, intraventricular, corpus callosum, cerebellar; 2 basal ganglia, thalamus, brainstem.
Modified tiers
0 hemispheric, corpus callosum, cerebellar; 1 basal ganglia, thalamus, brainstem. THREE tiers became TWO.
The shift
The modified score is EXACTLY 0.3 lower for every site except frontal and temporal - and that can move a patient a whole band.
Intraventricular
HAS NO MODIFIED TIER. The source does not list it. modified is null; do not assign one by analogy.
1.00 or less
89% obliteration without new deficit; 0% decline in modified Rankin scale.
1.01 to 1.50
70%; 13%.
1.51 to 2.00
64%; 20%.
2.00 or more
46%; 36%. The published bands OVERLAP at exactly 2.00; the higher band is applied.
Continuous
NO maximum - volume and age are unbounded. Not a grade, unlike spetzler-ponce, which grades MICROSURGICAL risk.
Scope
Radiosurgical outcome only. Does not choose the modality; ARUBA found medical management superior for UNRUPTURED AVMs.

What you enter

  • AVM volume.
  • Patient age.
  • Anatomical site.
Full field descriptions
  • AVM volume. Multiplied by 0.1 in both versions.
  • Patient age. Multiplied by 0.02 in both versions.
  • Anatomical site. Chosen ONCE; each version's tier is derived, because the two published ladders classify the same site differently [frontal = original tier 0, modified tier 0; temporal = original tier 0, modified tier 0; parietal = original tier 1, modified tier 0; occipital = original tier 1, modified tier 0; corpus-callosum = original tier 1, modified tier 0; cerebellar = original tier 1, modified tier 0; intraventricular = original tier 1, modified tier NOT LISTED; basal-ganglia = original tier 2, modified tier 1; thalamus = original tier 2, modified tier 1; brainstem = original tier 2, modified tier 1]
How this is calculated
Formula
0.1 x volume (cm^3) + 0.02 x age (years) + 0.3 x location tier. The SAME coefficients in both versions.

Pollock BE, Flickinger JC. A proposed radiosurgery-based grading system for arteriovenous malformations. J Neurosurg. 2002;96(1):79-85. Modified in Neurosurgery. 2008;63(2):239-243. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.