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

Fluids Hypertension Syndromes – Dr. Leonardo Izecksohn – page 181
Scheme III-4 (repeated): Direct ophthalmoscopic view of the Optic Nerve’s disk 0.2/1/0/0.5
(0.2=Cup-Disk diameter/ 1 = Cup depth/ 0 = no Lamina Cribosa’s pores visibility/ 0.5 = borders edemas)
and white sheaths around the arteries and veins on the Optic Disk: evident Cerebrospinal Fluid
Hypertension Syndrome.
Whether this rise of the Cerebrospinal Fluid pressure is too intense or remains too long, it causes visible
exuberant or giant edema, which can cause the Optic Nerve’s fibers damage with visual field partial
loss, configuring the Papilledema of the Benign Intracranial Hypertension (Pseudotumor cerebri)
with reduced Migraines (Scheme XIII-1). The exuberant chronic papilledema can cause many retinal
and sub-retinal damages, as:
Disc hyperemia,
Retinal hemorrhages,
Macular Star.
Retinal exudation and cotton-wool spots,
Macular edema.
Concentric circumferential lines (Patton lines).
Radial choroid and retinal folds.
Retinal pigment epithelial changes.
Peri-papillary sub-retinal neovessel membranes (Nguyen C and Borruat FX).
Sub-retinal hemorrhage.
Blurring of vision,
Decreased color perception,
Constriction of the visual field,
Loss of central visual acuity,
Blindness.
“The most common presenting symptom of Pseudotumor cerebri is headache, either intermittently or
permanent, usually worsen at the morning and with recumbent position.” (Mathews M K, Sergott R C,
Savino P J).