[Verse 1] Feeders threading in, the nidus tangled at the core, Draining veins stretched thin, high-pressure shunting through the floor, Spetzler-Martin grades it — size, location, venous depth, One through five, the surgeon weighs each point against the breath, Flow-related aneurysms clinging to the feeder wall, Intranidal weak spots — either one can make it fall, Two to four percent per year, that's hemorrhage odds untreated, Prior bleed, deep drainage, deep location — risk is seeded [Chorus] Сосуды рвутся тихо — кровь считает дни, Feeders first, vein last, don't cut the wrong supply, Смотри на градус риска, взвешивай слова — ARUBA said "observe" but the data showed its flaws, yeah, Feeders first, vein last, circumferential and slow, Облитерация — куда бы ты ни шёл [Verse 2] ARUBA randomized but only followed thirty months, Unruptured AVMs need decades, not a once, Young patients, lifelong risk — the trial critics argued hard, Selection bias skewed it, surgical cases scarred, So counsel honestly: natural history compounds with age, Radiosurgery carries latency — obliteration lags, Twelve to thirty-six months waiting while the gamma knife does work, Radiation necrosis lurks beneath the postop smirk [Chorus] Сосуды рвутся тихо — кровь считает дни, Feeders first, vein last, don't cut the wrong supply, Смотри на градус риска, взвешивай слова — ARUBA said "observe" but the data showed its flaws, yeah, Feeders first, vein last, circumferential and slow, Облитерация — куда бы ты ни шёл [Verse 3] Dural fistula draining — Borden tells you one through three, Cognard adds the detail of where cortical reflux flees, Transverse-sigmoid, ethmoidal, tentorial and SSS, Cortical venous reflux marks the ones that cause distress, Transarterial Onyx, transvenous coil the sinus down, Surgical disconnection when the endovascular drowns, Cavernous sinus fistula — Barrow classifies the flow, Direct traumatic shunting versus dural feeders, slow [Bridge] Cavernoma bleeds in centimeters, not the liters of an AVM, Brainstem lesions wait for two events before you enter them, CCM one, two, three — familial gene mutations mark the map, The developmental venous anomaly — hands off, never tap, Capillary telangiectasia glows on MRI contrast wash, Benign, no treatment needed, recognition is enough [Verse 4] Hypertensive hemorrhage — basal ganglia, thalamus, pons, Cerebellum bleeds compress the fourth ventricle and brainstem, Lobar bleeds in amyloid angiopathy, elderly cortex, INR reversed with four-factor PCC — correct it, CT-A spots the spot sign, predicts expansion overnight, Surgical thresholds: cerebellar over three centimeters, right, MISTIE, CLEAR, ENRICH — trials carving evacuation's place, Minimally invasive, thrombolytic — clearing clot with grace
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