This is a journey through the ideas, tools and frontiers redefining how we understand and operate on the human brain.
Each case, fully anonymized, is told as what it was: a problem, several alternatives and a reasoned decision. The pathology is the example; the focus is how one thinks.
Why the endonasal route changed the risk calculus in midline lesions.
Trigeminal neuralgia: when the cause is a vessel, the answer is not a lifelong drug.
Creating a new natural drainage pathway instead of implanting a permanent shunt.
Tractography reveals the nerve-fiber 'highways' that must be preserved. The route is planned before the first incision.
The patient drinks a compound that makes the tumor glow pink under a special light, sharply outlining the tissue to be removed.
It replaces the classic microscope with an ultra-high-definition 3D image shared by the entire surgical team.
MRI inside the operating room confirms —without ending the surgery— that the resection was complete.
Neurophysiology monitors critical functions in real time and warns before a maneuver can harm them.
From image analysis to surgical planning, AI is beginning to assist decisions that once relied on experience alone.
Interactive tools I build to think about and teach neurosurgery. These are evolving projects —Beta versions— for strictly educational purposes.
Interactive 3D model of linear and rotational impact (HIC and BrIC): coup and contrecoup, shear and diffuse axonal injury, on a parenchymal mesh that deforms in real time.
Open simulator → BETAHow cerebrospinal fluid flows and how a shunt regulates it (VP/VA/LP): pressure, body position, overdrainage and subdural collection risk.
Open simulator →Educational and outreach tools. They are not medical devices, do not process patient data and do not replace clinical judgment.
A careful selection of patient and family associations —in Argentina and worldwide— that support, inform and connect those living with these conditions.
Support, information and community for families.
Visit →The world's largest hydrocephalus patient network.
Visit →Brain tumor patients and families: support and information in Spanish.
Visit →International alliance of brain tumor organisations.
Visit →Global reference in facial pain and trigeminal neuralgia.
Visit →Support, information and rights for people with epilepsy.
Visit →Argentine community of stroke survivors and their families.
Visit →Guides and resources on stroke, in Spanish.
Visit →Argentine civil association for people with Parkinson's.
Visit →Global information and support, with Spanish content.
Visit →Editorial selection for informational purposes. Inclusion implies no commercial link or endorsement; links open external sites.
For nearly a century, operating on the brain meant opening it up in order to see. Today, much of the progress lies in the opposite: seeing better to open less —or not at all.
Radiosurgery treats tumors without a single incision. Endoscopy reaches the skull base through the nose. Fluorescence makes a tumor glow to separate it from healthy tissue. These are not gadgets: they are a shift in how decisions are made.
Read the full essay →Not all of this is part of daily practice —yet. But following the field's evolution closely is part of practicing it seriously.
In 2025, implants restored speech to paralyzed patients.
A brain pacemaker that self-adjusts to the brain's activity.
Treating tremor from outside the skull, with no incision.
Sub-millimetric precision and stability beyond the human hand.
Decisions guided by each tumor's molecular profile.
Simulating a surgery on a virtual replica before performing it.
Detecting and classifying disease with unprecedented precision.
From the OR to predicting outcomes and complications.
Curated selection of recent literature. The list updates automatically from PubMed (NEJM, Nature Medicine, Journal of Neurosurgery, JAMA) and always links to the original source.
I am a neurosurgeon. I devote my work to a discipline that, like few others, demands both technical rigor and human care at once.
I trained at the Hospital Militar Central residency, completed a fellowship in endoscopic skull base surgery at Ohio State University and specialized at UBA. Today, beyond operating, I lead and teach. This publication is my way of sharing where all of this is heading.