Frontal AVM

Numbers

Location

Arterial Supply

Venous Drainage

Eloquence

8.0%

Cone-shaped convexity AVMs based on the lateral frontal surface (SFG, MFG, or IFG), extending toward the ventricle.

-Primarily branches from the MCA Superior Trunk (OrbFrA, PreFrA, PreCenA, CenA).
-ACA contributions are typically minimal or absent.

Superficial:
-Ascending frontal veins to the SSS (FrPolV, AntFrV, MidFrV, PosFrV, PreCenV, CenV), OR
-Descending to superficial sylvian veins (SupSylV).

Dominant hemisphere:
-Posteriorly: motor areas (precentral gyrus)
-Inferiorly in Broca’s speech area (IFG) in the

3.5%

Located solely on the medial frontal surface, often deep within the cingulate gyrus, or in the medial aspect of the superior frontal gyrus.

-Exclusively ACA branches (OrbFrA, FrPolA, internal frontal arteries, PcaA, CmaA).
-MCA does not contribute.

-Superficial: Ascending medial frontal veins (MedFrV) to the SSS.
-Deep: pericallosal veins (PcaV) and the ISS.

Abutting the motor strip in the paracentral lobule.

4.0%

Occupies both the medial and lateral surfaces at the superior medial corner, placing the nidus in the vascular watershed area.

Dual arterial supply from:
-MCA Superior Trunk branches (laterally)
-ACA branches (medially).

-Superficial: both lateral and medial frontal veins that course to the SSS.

Eloquent when located posteriorly, adjacent to the motor areas (precentral gyrus, paracentral lobule).

3.5%

Located on the basal frontal surface along the anterior cranial fossa floor (gyrus rectus or orbital gyri).

Dual arterial supply:
-MCA (OrbFrA, PreFrA posterolaterally)
-ACA feeders (OrbFrA, FrPolA, and A1 segment branches anteromedially).

-Superficial to the SSS (anterior OrbFrV or FrPolV): Usual
- Deep to the BVR (OlfV or posterior OrbFrV): occasionally

Cortex is considered non-eloquent for grading, but careful dissection is needed to preserve the olfactory apparatus.

3.5%

Based on the sylvian surface in the frontal operculum (pars orbitalis, pars triangularis, pars opercularis).

-Primarily M3 opercular branches of the MCA.
-ACA does not supply these AVMs.

Sylvian veins (FrSylV, SupSylV, DeepSylV).

Highly eloquent in the dominant hemisphere due to the location of Broca’s speech area (pars triangularis, pars opercularis).