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

Fluids Hypertension Syndromes – Dr. Leonardo Izecksohn – page 169
3.The third effect of the Valsalva maneuver is the rise of the Cerebrospinal fluid pressure, consequent
to the rise of the intra-cranial venous pressure. This can be felt as a headache. Whether this
Cerebrospinal fluid hypertension reaches higher values than the arterial pressure inside the brain, it can
cause ischemic damage anywhere in the brain.
4.The fourth effect of the Valsalva maneuver is a reduction of the blood supply to the brain, with
few oxygen and accumulation of carbonic gas: “Profound reductions in middle cerebral artery blood
velocity (mean) were observed … during the maintained Valsalva maneuver (-21 +/- 3% together with
an elevation in central venous pressure to 40 +/- 7 mmHg). Responses to performance of the Valsalva
maneuver with and without exercise were similar…”(Pott F, and others).
5.The fifth effect of the Valsalva maneuver is a stimulus to the right-to-left blood shunt in the
heart which has patent foramen ovale, or in the lung which has artery-venous malformation. This
causes the venous blood with excessive carbonic gas and few oxygen to be distributed to the brain and
the whole body together with the arterial blood. It causes vasodilation in the brain’s arteries, auras and
migraines, besides other pathologies.
Other etiologies, similar to Valsalva maneuver, also raise the cranial venous pressures and can cause
the glaucoma:
A- Queckenstedt test.
B- High resistance wind instrument playing.
C- Sirsasana (Shirshásana) (headstand) yoga posture.
D- Tight neckties.
A- Queckenstedt test: The manual pressure applied to both jugular veins to elevate the cranial
venous pressure, known as the “Queckenstedt test”, also cause the firsts three above effects, rising
simultaneously the Cerebrospinal, Intraocular and Inner Ears Fluids pressures, and worsening the migraine's
aches: “The Queckenstedt test (30 seconds on 39 patients with acute migraine attacks) aggravated
headache intensity in both sitting and supine positions. The presence of throbbing pain and higher
pain intensities was associated with the Queckenstedt test effect in the supine position.” (Chou C H,
and others).
B- High resistance wind instrument playing causing Normal (Peak) tension Glaucoma:
“High and low resistance wind musicians experience a transient rise in their intraocular pressure
while playing their instruments as a result least in part of uveal engorgement. The magnitude of intraocular
pressure increase is greater in high resistance wind (trumpet and oboe) players. High resistance
wind musicians had a small but significantly greater incidence of visual field loss than other musicians,
which was related to life hours of playing. The cumulative effects of long-term intermittent intraocular
pressure elevation during high resistance wind instrument playing may result in glaucomatous
damage, which could be misdiagnosed as normal-tension glaucoma.” (Schuman JS, et al.)
This is really a Normal (Peak) tension glaucoma!
C- Sirsasana (Shirshásana) (headstand) yoga posture causing Normal (Peak) Tension Glaucoma:
“There was a uniform 2-fold increase in the intraocular pressure during Sirsasana, which was maintained
during the posture in all age groups irrespective of the ocular biometry and ultrasound pachymetry.”
(Baskaran M, and others).
D- Tight neckties causing Normal (Peak) Tension Glaucoma:
“A tight necktie may cause an increase in Intraocular Pressure in susceptible individuals and should
be included among the confounders of accurate intraocular pressure measurement and considered as a
risk factor for increased intraocular pressure.” (Teng C, and others).
This is a similar pathophysiology of the Queckenstedt test explained above.