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

Fluids Hypertension Syndromes – Dr. Leonardo Izecksohn – page 165
XII v) Vicious cycles worsening and lengthening the migraine: There are some vicious cycles
which can turn a short and mild disturbance or headache into a strong and lengthened migraine. Here
are four vicious cycles, but there must be others:
1- Any ache causing physical stress; releasing adrenaline (Epinephrine), cortisone, vasopressin, other
vasoconstrictors, and causing neural reflexes; causing vasoconstriction and water retention; causing rebound
vasodilation and fluid’s exudation; causing Cerebrospinal fluid pressure rising; causing more
aches and migraines.
2- Fear of more aches or psychological stress, causing respiratory inhibition, causing few oxygen (O2)
and excessive carbon dioxide (CO2) in the arterial blood, causing vasodilation in the brain and eyes,
causing excessive fluids liberation, causing Fluids Hypertension, causing aches and the fear of more
aches.
3- Little migraines with inadequate medication or excessive hydration, causing more fluid’s secretion
and retention, causing more Fluid Hypertension, causing bigger and stronger migraines.
4- A little Cerebrospinal fluid pressure rise, compressing the Pituitary gland and releasing excessive
vasopressin, which causes water retention by the kidneys, increasing the Cerebrospinal fluid pressure,
causing migraines and compressing more the Pituitary.
XII w) All these fluids are constantly drained. In the entire body, all the extra-cellular fluids are
physiologically continuously drained by venous capillaries, lymphatic system, Schlemm’s canal, resorption,
or other. Meanwhile, the choroid and retina, the brain, and the inner ears have no lymphatic
drainage, which turns these spaces prone to retention of any exuded liquid.
We conclude that the pathophysiology common to the three Fluids Hypertension Syndromes is:
a - Many etiologies cause the excessive fluids exudation from the arterial capillaries.
b - When the drainage in that place is sufficient for that excessive volume, the extra-cellular fluid is
drained and nothing occurs.
c - When the drainage is insufficient and in a soft expansible tissue, it swells as an edema.
d - When the drainage is insufficient and inside a closed space, the extra-cellular fluid pressure raises
and the stretched structures aches as migraines and variants.
e - When the stretched structure is a nerve in a hard lamina cribosa or foramen, the passing by nerve
fibers suffer the consequent damage.
f - When the stretching fluid pressure surpasses the arterial perfusion pressure at any place, it causes
the collapse of the arterial supply and the ischemia causes its damage.
XII x) Pathophysiology of the Optic Nerve’s Lamina Cribosa:
a- Part of it is described above, at the chapter: “IX – The Optic Nerve’s Lamina Cribosa Pores –
Visibility and Pathophysiology.”
b- As bigger is the glaucomatous cup, it is easier to worsen it, by 2 vicious cycles:
1- The same intraocular pressure measured in mmHg varies over the Optic Nerve's disk when it is
measured in grams per square millimeter, because the disk's surface area varies. How bigger is the
disk's surface, so bigger is the intraocular pressure in grams over it. As the glaucomatous disk's cup increases,
so the total surface of the disk's borders added with the inner cup surface also increases, and
consequently also increases the pressure in grams over it, even with a steady pressure in mmHg.
This increasing pressure in grams turns the Optic Nerve's glaucomatous big cup more prone to increase
more and more the same cup, worsening the glaucoma. It is a vicious cycle.
2- As the glaucomatous Optic Nerve's cup increases, more distended, thin and weaker becomes the
Lamina Cribosa, to resist against the intraocular pressure. So, the intraocular pressure can easily distend
more and more the lamina cribosa and worsen the glaucoma. It is another vicious cycle.
Both vicious cycles are seen at the Scheme XII-2.