OBJECTIVE: @entity2758 (AVMs) (i.e., those greater than 6 cm at maximum diameter) are difficult to treat and often carry higher treatment morbidity and mortality rates than do smaller AVMs. In this study, we reviewed the treatment, angiographic results, and clinical outcomes in 53 @entity1 with @entity2758 who were treated at Stanford between 1987 and 2001. METHODS: The @entity1 selected included 20 males (38%) and 33 females (62%). Their presenting symptoms were @entity548 (n = 20; 38%), @entity410 (n = 18; 34%), @entity10 (n = 8; 15%), and progressive @entity51 (n = 7; 13%). One @entity1 was in Spetzler-Martin Grade III, 9 were in Spetzler-Martin Grade IV, and 43 were in Spetzler-Martin Grade V. The mean @entity7026 size was 6.8 cm (range, 6-15 cm). @entity7026 venous drainage was superficial (n = 7), deep (n = 20), or both (n = 26). At presentation, 31 @entity1 (58%) were graded in excellent @entity16 , 17 were graded good (32%), and 5 were graded poor (9%). RESULTS: The @entity1 were treated with surgery (n = 27; 51%), @entity887 (n = 52; 98%), and/or radiosurgery (n = 47; 89%). Most @entity1 received multimodality treatment with @entity887 followed by surgery (n = 5), @entity887 followed by radiosurgery (n = 23), or @entity887 , radiosurgery, and surgery (n = 23). Nineteen @entity1 (36%) were completely cured of their @entity2758 , 90% obliteration was achieved in 4 @entity1 (8%), less than 90% obliteration was achieved in 29 @entity1 (55%) who had residual AVMs even after multimodality therapy, and 1 @entity1 was lost to follow-up. Of the 33 @entity1 who either completed treatment or were alive more than 3 years after undergoing their most recent radiosurgery, 19 @entity1 (58%) were cured of their AVMs. The long-term treatment-related morbidity rate was 15%. The clinical results after mean follow-up of 37 months were 27 excellent (51%), 15 good (28%), 3 poor (6%), and 8 dead (15%). CONCLUSION: The results in this series of @entity1 with @entity2758 , which represents the largest series reported to date, suggest that selected symptomatic @entity1 with @entity2758 can be treated successfully with good outcomes and acceptable risk. Multimodality treatment is usually necessary to achieve @entity7026 .

Multimodality treatment of giant XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity7026 :: ('MESH:D002538', 'Disease') :: ['AVM', 'AVM obliteration'] @entity410 :: ('MESH:D012640', 'Disease') :: ['seizures'] @entity2758 :: ('MESH:D001165', 'Disease') :: ['Giant arteriovenous malformations', 'giant AVMs'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhage'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neurological condition'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurological deficits'] @entity887 :: ('MESH:D004617', 'Disease') :: ['embolization'] @entity10 :: ('MESH:D006261', 'Disease') :: ['headaches']
@entity7026 :: (MESH:D002538,Disease) :: ['intracranial arteriovenous malformations']
