Fluids Hypertension Syndromes: Migraines, Headaches, Normal ...

Fluids Hypertension Syndromes – Dr. Leonardo Izecksohn – page 163
f) Parasympathetic Neural reflex: It can cause miosis (pupil contraction), which is a parasympathetic
stimulus from the oculomotor nerve (3rd. Cranial nerve) to the Nasociliary ganglion behind the eye,
and short ciliary nerves to the eye. This is another connection in the brain stem.
g) Parasympathetic Neural reflex: It can cause vasodilation of the conjunctiva (“eyes” redness) and
in the eyelids (“eyes” edema). These are parasympathetic stimulus, probably via the brain stem and the
3rd. Cranial nerve.
The distinction between these aches is provided by local anesthesia in migraine patients: “The
sphenopalatine ganglion block induced by intranasal Lidocaine causes reduction of the Migraines but
the Allodynia remained unchanged in spite of the pain relief… During migraine attacks 63% of the patients
presented with ipsilateral lacrimation (tearful), 50% with ipsilateral nasal congestion, and 36%
with rhinorrhea…The intranasal lidocaine application stopped the tearfulness, decongested the nose,
and ended the rhinorrhea in almost all cases.” “From the 15 (patients that) experienced the pain only
within the frontal region of the cranium … nasal lidocaine reduced the pain (by more than 50%) in 8
patients”. “In 7 (54%) of the 13 cases in which we documented the changes in pain intensity over both
the frontal and occipital regions, the application of nasal lidocaine reduced (only) the frontal pain selectively.”
(Yarnitsky D and others). Explanation: In a patient with aches from the Optic Nerves
stretched by the Cerebrospinal Fluid Hypertension, the anesthesia of the Sphenopalatine ganglion
blocks part of the frontal Migraines from the neural reflex causing the intra-nasal edema, and also
blocks the neural reflexes of tearfulness, nasal congestion and rhinorrhea caused secondarily at the
parasympathetic fibers that stimulate the lacrimation and pass by this ganglion. It can not block all the
other body’s nerves that present allodynia consequent to their stretching by the Cerebrospinal Fluid Hypertension.
It also cannot block the occipital migraine, which is caused by the connections in the central
nervous system between the 5 th . cranial nerve (Trigeminal) and the Greater Occipital Nerve.
To elucidate precisely which Migraines are from the stretch of the Optic Nerve’s Lamina Cribosa, it
is necessary to anesthetize the Ciliary ganglion behind the eye, by the retro-bulbar block during the Migraine
crisis, and verify the aches reduction. We suppose that no doctor has ever done this.
The aches reduction by Trigeminal ganglion block, applied to patients with Trigeminal neuralgia,
blocks all facial neural aches: those primary caused by the suffering nerve, or caused by the Trigeminal
ganglion compressed by the Cerebrospinal Fluid's Hypertension, and those neural reflexes secondary to
the primary aches: “Trigeminal ganglion block commonly is used for diagnostic and prognostic purposes
when considering trigeminal neurolysis for patients with trigeminal neuralgia” (Wheeler AH).
The anesthesia of the Trigeminal ganglion blocks all the sensory nerves from the face, including the
aches originated on the Optic Nerves.
The anesthesia of the Greater Occipital nerve in a patient with "tension" migraine, blocks only the allodynia
of this nerve, which has no pathology: it has only secondary aches.
XII s) Fluids hypertension caused by cardiac patent foramen ovale or intrapulmonary right-toleft
shunt:
In the patient with patent cardiac foramen ovale or intrapulmonary right-to-left shunt, the pathophysiology
is:
- The venous blood with few oxygen and low carbonic gas passes from the right to the left cardiac atrium,
mixing with the arterial blood.
- This venous blood with few oxygen and with carbonic gas goes with the arterial blood to the eyes and
brain.
- The brain and eyes, receiving blood with low oxygen and high carbonic gas, present arterial vasodilation
and auras.
- The vasodilation increases the blood serum exudation and fluids’ secretions, which increase the ocular,
inner ears and cerebrospinal fluids’ pressures.
- Whether the fluids already are at a high pressure caused by other risk factors, the adding up of more
this one pressure can cause migraines. So, the risk factors become etiologies.
- Whether the migraine’s pressure level is not attained, the patient has auras without migraines, the denominated
“Acephalgic Migraines”.