Alexander Micko
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View article: Minimally Invasive Supraorbital vs. Traditional Pterional Approaches in Unruptured Aneurysm Surgery: Evaluating Risks and Results
Minimally Invasive Supraorbital vs. Traditional Pterional Approaches in Unruptured Aneurysm Surgery: Evaluating Risks and Results Open
Background/Objectives: Intracranial aneurysms affect 3–5% of the population and are associated with high morbidity and mortality, particularly after rupture. Treatment options for unruptured aneurysms include microsurgical clipping, with t…
View article: Hyperbaric oxygen therapy for brain abscesses: A useful adjuvant treatment for a faster recovery
Hyperbaric oxygen therapy for brain abscesses: A useful adjuvant treatment for a faster recovery Open
Brain abscesses are still characterized by substantial case fatality rates and a high risk of permanent functional impairment. Standard treatment consists of long-term antimicrobial therapy and various neurosurgical interventions. In a few…
View article: Launching Stealth AutoGuideTM robot for stereotactic biopsy procedures in a neurosurgical centre: learning curve and workflow optimization
Launching Stealth AutoGuideTM robot for stereotactic biopsy procedures in a neurosurgical centre: learning curve and workflow optimization Open
Background Accurate histological analysis is crucial for confirming intracerebral neoplasia due to the diverse array of potential diagnoses presented by imaging. In the realm of biopsy techniques, the use of robot-based systems is on the r…
View article: Bilateral inferior petrosal sinus sampling with human CRH stimulation in ACTH-dependent Cushing's syndrome: results from a retrospective multicenter study
Bilateral inferior petrosal sinus sampling with human CRH stimulation in ACTH-dependent Cushing's syndrome: results from a retrospective multicenter study Open
Objective Bilateral inferior petrosal sinus sampling (BIPSS) is regarded as the gold standard to differentiate between Cushing´s disease (CD) and ectopic Cushing's syndrome (ECS). However, published data on the diagnostic value of addition…
View article: Validation of Myc-Associated Protein X (MAX) regulation in growth hormone secreting and nonfunctional pituitary adenoma
Validation of Myc-Associated Protein X (MAX) regulation in growth hormone secreting and nonfunctional pituitary adenoma Open
Introduction Many patients with growth hormone-secreting pituitary adenoma (GHPA) fail to achieve biochemical remission, warranting investigation into epigenetic and molecular signatures associated with tumorigenesis and hormonal secretion…
View article: Elevated EMMPRIN Serum Levels Indicate Plaque Vulnerability in Patients With Asymptomatic High Grade Carotid Stenosis
Elevated EMMPRIN Serum Levels Indicate Plaque Vulnerability in Patients With Asymptomatic High Grade Carotid Stenosis Open
Patients with high risk plaques according to ultrasound and histopathological characteristics demonstrated increased serum EMMPRIN levels. EMMPRIN on top of clinical risk factors, including age, gender, and duplex sonography may be used fo…
View article: LBMON175 Nadir Growth Hormone Concentrations In Patients With Acromegaly Relate To Disease Activity, Glucose Metabolism, BMI And Sex
LBMON175 Nadir Growth Hormone Concentrations In Patients With Acromegaly Relate To Disease Activity, Glucose Metabolism, BMI And Sex Open
Background In healthy subjects, nadir growth hormone (GH) concentrations following an oral glucose load are related to BMI, gender and estrogen use. To date, very few data exist on factors influencing nadir GH in patients with acromegaly. …
View article: Diagnostic criteria of small sellar lesions with hyperprolactinemia: Prolactinoma or else
Diagnostic criteria of small sellar lesions with hyperprolactinemia: Prolactinoma or else Open
Objective To evaluate the combined predictive value of MRI criteria with the prolactin-volume-ratio (PVR) to differentiate prolactinoma from non-prolactinoma, in small sellar lesions with hyperprolactinemia. Methods Retrospective analysis …
View article: Aggressive pituitary tumours and carcinomas, characteristics and management of 171 patients
Aggressive pituitary tumours and carcinomas, characteristics and management of 171 patients Open
Objective To describe clinical and pathological characteristics and treatment outcomes in a large cohort of aggressive pituitary tumours (APT)/pituitary carcinomas (PC). Design Electronic survey August 2020–May 2021. Results 96% of 171 (12…
View article: Dumbbell-shaped pituitary adenomas: prognostic factors for prediction of tumor nondescent of the supradiaphragmal component from a multicenter series
Dumbbell-shaped pituitary adenomas: prognostic factors for prediction of tumor nondescent of the supradiaphragmal component from a multicenter series Open
OBJECTIVE Dumbbell-shaped pituitary adenomas (DSPAs) are a subgroup of macroadenomas with suprasellar extension that are characterized by a smaller diameter at the level of the diaphragma sellae opening compared with the supradiaphragmal t…
View article: Diagnosis of Pituitary Adenoma Biopsies by Ultrahigh Resolution Optical Coherence Tomography Using Neuronal Networks
Diagnosis of Pituitary Adenoma Biopsies by Ultrahigh Resolution Optical Coherence Tomography Using Neuronal Networks Open
Objective Despite advancements of intraoperative visualization, the difficulty to visually distinguish adenoma from adjacent pituitary gland due to textural similarities may lead to incomplete adenoma resection or impairment of pituitary f…
View article: Morpho-Molecular Metabolic Analysis and Classification of Human Pituitary Gland and Adenoma Biopsies Based on Multimodal Optical Imaging
Morpho-Molecular Metabolic Analysis and Classification of Human Pituitary Gland and Adenoma Biopsies Based on Multimodal Optical Imaging Open
Pituitary adenomas count among the most common intracranial tumors. During pituitary oncogenesis structural, textural, metabolic and molecular changes occur which can be revealed with our integrated ultrahigh-resolution multimodal imaging …
View article: Focal Subthalamic Atrophy after Long‐Term Deep Brain Stimulation in Parkinson's Disease
Focal Subthalamic Atrophy after Long‐Term Deep Brain Stimulation in Parkinson's Disease Open
Deep brain stimulation (DBS) is a surgical procedure that is increasingly being applied to selected patients with movement disorders, and other conditions. In Parkinson's disease (PD), DBS is particularly effective against disabling and ph…
View article: Long-Term Corticotroph Function Following Cure of Cushing’s Syndrome
Long-Term Corticotroph Function Following Cure of Cushing’s Syndrome Open
Introduction: Hyper- and hypofunction of the hypothalamic-pituitary-adrenal (HPA) axis in Cushing’s syndrome (CS) and Addison’s disease (AD) is associated with disturbances of classical feedback mechanisms. Time to recovery of adrenal func…
View article: Acute and Life-threatening Complications in Cushing Syndrome: Prevalence, Predictors, and Mortality
Acute and Life-threatening Complications in Cushing Syndrome: Prevalence, Predictors, and Mortality Open
Context Cushing syndrome (CS) results in significant morbidity and mortality. Objective To study acute and life-threatening complications in patients with active CS. Methods We performed a retrospective cohort study using inpatient and out…
View article: Towards ultrahigh resolution OCT based endoscopical pituitary gland and adenoma screening: a performance parameter evaluation
Towards ultrahigh resolution OCT based endoscopical pituitary gland and adenoma screening: a performance parameter evaluation Open
Ultrahigh resolution optical coherence tomography (UHR-OCT) for differentiating pituitary gland versus adenoma tissue has been investigated for the first time, indicating more than 80% accuracy. For biomarker identification, OCT images of …
View article: The endonasal patient reference tracker: a novel solution for accurate noninvasive electromagnetic neuronavigation
The endonasal patient reference tracker: a novel solution for accurate noninvasive electromagnetic neuronavigation Open
OBJECTIVE Electromagnetic (EM) navigation provides the advantages of continuous guidance and tip-tracking of instruments. The current solutions for patient reference trackers are suboptimal, as they are either invasively screwed to the bon…
View article: Development and clinical validation of a grading system for pituitary adenoma consistency
Development and clinical validation of a grading system for pituitary adenoma consistency Open
OBJECTIVE Pituitary adenoma (PA) consistency, or texture, is an important intraoperative characteristic that may dictate operative dissection techniques and/or instruments used for tumor removal during endoscopic endonasal approaches (EEAs…
View article: Impact of tumor characteristics and pre- and postoperative hormone levels on hormonal remission following endoscopic transsphenoidal surgery in patients with acromegaly
Impact of tumor characteristics and pre- and postoperative hormone levels on hormonal remission following endoscopic transsphenoidal surgery in patients with acromegaly Open
OBJECTIVE Acromegaly is a disease of acral enlargement and elevated serum levels of insulin-like growth factor–1 (IGF-1) and growth hormone (GH), usually caused by a pituitary adenoma. A lack of consensus on factors that reliably predict o…
View article: Increased ATP synthesis might counteract hepatic lipid accumulation in acromegaly
Increased ATP synthesis might counteract hepatic lipid accumulation in acromegaly Open
Patients with active acromegaly (ACRO) exhibit low hepatocellular lipids (HCL), despite pronounced insulin resistance (IR). This contrasts the strong association of IR with nonalcoholic fatty liver disease in the general population. Since …
View article: Ectopic Cushing’s syndrome in a patient with inferior petrosal sinus sampling indicating pituitary‐dependent ACTH secretion
Ectopic Cushing’s syndrome in a patient with inferior petrosal sinus sampling indicating pituitary‐dependent ACTH secretion Open
In an unclear case of Cushing's syndrome, IPSS identifies the origin of ACTH secretion, and together with MRI enables the localization of an ectopic corticotroph adenoma in the parasellar or cavernous sinuses region.
View article: Efficacy of Temozolomide Therapy in Patients With Aggressive Pituitary Adenomas and Carcinomas—A German Survey
Efficacy of Temozolomide Therapy in Patients With Aggressive Pituitary Adenomas and Carcinomas—A German Survey Open
Context Despite growing evidence that temozolomide (TMZ) therapy is effective for the treatment of aggressive pituitary tumors (APTs) or carcinomas (PCs), individual therapy decisions remain challenging. Objective We therefore aimed to rep…
View article: Line Scan Raman Microspectroscopy for Label-Free Diagnosis of Human Pituitary Biopsies
Line Scan Raman Microspectroscopy for Label-Free Diagnosis of Human Pituitary Biopsies Open
Pituitary adenomas are neoplasia of the anterior pituitary gland and can be subdivided into hormone-producing tumors (lactotroph, corticotroph, gonadotroph, somatotroph, thyreotroph or plurihormonal) and hormone-inactive tumors (silent or …