Neurocirugía
Cartagena, Colombia
Joined May 2018
- Tweets1K
- Following508
- Followers223
- Likes5.5K
Hernando Alvis, MD retweeted
There’s more information in every CT scan. Opportunistic screening can extract biomarkers such as bone density, body composition and vascular calcification from existing imaging, expanding radiology’s role in proactive patient care. @SidDograMD @NYUImaging bit.ly/4jHPkWf
Hernando Alvis, MD retweeted
Guarda esta imagen, luego me agradeces.
Si un paciente con FA presenta un ACVi mientras recibe anticoagulación, el riesgo de transformación hemorrágica obliga a suspenderla.
La pregunta de siempre es: ¿cuándo reiniciarla?
Esta gráfica ayuda a responderlo y, en general, favorece el reinicio durante la primera semana especialmente si no existe transformación hemorrágica o no es extensa la isquemia.
Hernando Alvis, MD retweeted
Fundamental Principles of Hemodynamics: Bernoulli, Poiseuille & Flow Regimes
👉Bernoulli’s principle links velocity and pressure: flow acceleration through stenosis lowers lateral pressure; Doppler uses ΔP ≈ 4V².
👉Hagen–Poiseuille’s law shows Q = πr⁴ΔP/(8μL), making vessel, shunt, conduit, or cannula radius a dominant determinant of flow.
👉Laminar flow is orderly; turbulence is favored by ↑velocity, ↑diameter, and ↓viscosity, increasing energy loss and abnormal wall shear stress.
Hernando Alvis, MD retweeted
ソフトのインストールなしで、画像から3Dモデルへ。
SegRef3D Liteでは、CT・MRIや光学／電子顕微鏡画像をブラウザでセグメンテーション・修正・3D再構築できます。SAM2／TotalSegmentatorはGoogle Colab連携で利用できます。
satorumuro.github.io/SegRef3…
Hernando Alvis, MD retweeted
"Spinal Metastasis Reporting: Evidence-Based Recommendation on Behalf of the American Society of Spine Radiology Education and Standards Committee"
doi.org/10.3174/ajnr.A9211
Hernando Alvis, MD retweeted
This is a really cool and original review on the role of invasive monitoring after decompressive craniectomy, pointing out the massive changes in brain circulatory and pressure-volume and CSF flow dynamics that occur.
Main message: rather than an ICP threshold of >22 mm Hg relating to poor outcome, after DC igt's lower; most studies find the threshold is in the range of >12-14 mm Hg.
Similarly a CPP >40-50 mm Hg may be adequate.
Makes me want to leave ICP monitors in after DC.
#curingcoma
link.springer.com/article/10…
Hernando Alvis, MD retweeted
A psychedelic compound best known for its effects on the brain may help prevent one of chemotherapy's most debilitating side effects—chemotherapy-induced peripheral neuropathy, researchers report in Science.
In mouse models, as few as two doses of psilocybin given before treatment durably prevented CIPN through multiple cycles of chemotherapy, while preserving both nerve function and the therapies’ tumor-killing effects.
📄: scim.ag/4ctTNaF
#SciencePerspective: scim.ag/466LJcj
Hernando Alvis, MD retweeted
#ONSNew SpineForge Planner: Free and Open-Source Software for Spinal Alignment Analysis and Surgical Planning bit.ly/4y75ixz by Bilal Bahadır Akbulut @bornovadh @CNS_Update @JohnHShinMD
Hernando Alvis, MD retweeted
¿Cómo retirar glucocorticoides sin provocar insuficiencia suprarrenal?
Dosis altas: descenso relativamente rápido hasta ~10 mg/d de prednisolona.
De 10 → 5 mg/d: reducir más lentamente.
Cerca de 5 mg/d: el taper debe ser más gradual para permitir recuperación del eje HPA.
Si hay uso prolongado o síntomas: cortisol 8 a. m. <3 µg/dL sugiere insuficiencia suprarrenal; >15 µg/dL la hace poco probable; 3–15 µg/dL → considerar prueba con ACTH.
Punto clave del paper: no tiene mucho sentido hacer un taper ultralento mientras el paciente sigue muy por encima de la dosis fisiológica. El cuello de botella delicado comienza al acercarse a dosis fisiológicas.
Hernando Alvis, MD retweeted
A brilliant new @Nature synthesis of what we know about Alzheimer's disease pathogenesis, which is non-linear, with discrete phases (Figure), and notable inflection and transition points. Also helps to explain why symptoms do not correlate with underlying pathology.
nature.com/articles/s41586-0…
🤖 Made with AI
Hernando Alvis, MD retweeted
Applications are open for the 20th Latin American Summer School on Epilepsy!
Join us in Medellín in February! View more information and apply for LASSE XX at ilae.org/lasse2027
Hernando Alvis, MD retweeted
Lamentablemente falleció la joven de 20 años que corrió la media maratón de Medellín .
Los que no han leído este artículo que les hice y corren o tienen un amigo o familiar que lo hace, por favor léanlo y compártalo .🙏
Hernando Alvis, MD retweeted
Why do some aneurysms remain patent after flow diversion? 🧠
In 185 aneurysms, branch involvement was the strongest predictor of incomplete occlusion.
But not all branches behaved alike—accounting for collateral circulation improved prediction scores.
🔗 bit.ly/3TKoAtm
#JNIS #FlowDiversion #Aneurysm #Neurointervention
Hernando Alvis, MD retweeted
Management of anticoagulation in patients with brain metastasis | Hematology, ASH Education Program | American Society of Hematology ashpublications.org/hematolo…
Hernando Alvis, MD retweeted
Actualizaciones 2026 de Mieloma Múltiple (MM) de American Journal of Hematology. Cambian algunas cosas:
🔴 La terapia inicial ya no es triple. Sino cuádruple: Dara-VRd o Isa-VRd para todos, sean o no candidatos a trasplante.
🔴 El trasplante dejó de ser "el primer paso". Va después de 3–4 ciclos, y en riesgo estándar se puede diferir hasta la primera recaída.
🔴 Nueva definición de alto riesgo (IMS/IMWG): t(4;14) sola ya NO es alto riesgo. Necesita gain(1q) o del(1p) concomitante. Igual gain(1q) aislado.
🔴 El mantenimiento sí mejora la mortalidad. Estándar: lenalidomida + anti-CD38. 2 años en riesgo estándar, hasta progresión en alto riesgo.
🔴 Mieloma latente de alto riesgo: daratumumab 3 años (AQUILA Trial). Antes era solo observar.
🔴 Primera recaída: cilta-cel o Tec-Dara desplazan al triple clásico.
🔴 Ya no: trasplante en tándem, consolidación post-trasplante y alogénico.
Es un tema complejo pero muy interesante. Completo en (t.me/memodiapparticulos).
Hernando Alvis, MD retweeted
Why do radiculopathies, which usually cause prominent sensory symptoms, have normal sensory nerve conduction studies? The answer is a cool demonstration of neuroanatomy and physiology.
#neurology #neuroX #MedSchool #FOAMed #EMG #neuromuscular #medicalstudent #neuro
Hernando Alvis, MD retweeted
Perspective essay by Matthew K. Wynia, MD, MPH: Resistance, Strategic Compromise, or Complicity? Physicians’ Choices under Ethical Pressure nej.md/4xA8H7t
#MedicalEthics #PublicHealth
ALT The image titled "The Collaboration–Defiance Spectrum of Responses to Pressure to Violate Professional Ethics" illustrates four interconnected zones: Collaboration, Complicity, Resistance, and Defiance. Each zone contains two stages: Collaboration includes "Enthusiastic collaboration" and "Willing collaboration," Complicity includes "Self-serving complicity" and "Defensive complicity," Resistance includes "Covert resistance" and "Overt resistance," and Defiance includes "Open defiance" and "Exit." The caption below the image reads as follows: "All points on the spectrum can be reasonable, depending on circumstances. Resistance and defiance comprise an escalatory set of options, so in general, resistance should be attempted before quitting is justified."
Hernando Alvis, MD retweeted
A one hour walk in nature increases a core region in the brain for inhibiting stress.
Nature is neuroplasticity.
Hernando Alvis, MD retweeted
✅ TROMBOSIS VENOSA CEREBRAL. REVISIÓN 2026
PDF libre acceso‼️👇
📖 Cerebral Venous Thrombosis: Pathophysiologic Insights, Clinical Evaluation Tools, and Novel Therapeutic Strategies mdpi.com/2075-4418/16/9/1308
