Patients were randomised ( by web-based system , in a 1:1 ratio , with random permuted block design [ block size 2 , 4 , or 6 ] , stratified by clinical site ) to medical management with interventional therapy ( ie , neurosurgery , embolisation , or stereotactic radiotherapy , alone or in combination ) or medical management alone ( ie , pharmacological therapy for neurological symptoms as needed ) .