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

Fluids Hypertension Syndromes – Dr. Leonardo Izecksohn – page 27
We finally planned to clarify our last doubts: we made one big statistic concerning only the first ophthalmological
examination of 1,270 consecutively examined outpatients on the year 2005, who independently
came to our ophthalmological clinic: We searched after the Primary Headaches disorders and
variants. We excluded the patients already examined, medicated or suffering with any sickness known
to cause headaches, or likely complaining false aches. The main sheet had 1270 rows and 167 columns:
65 columns with possible signs, symptoms and sicknesses, added with 17 columns of possible grouped
etiologies, and more 85 columns of correlations between them. This main sheet originated another 75
sheets to individually analyze each correlation. Now we know that we missed many important etiologies,
as chocolate and smoking. Its full analysis took more than one year. Many tables were discarded.
The descriptions of these findings and conclusions are the 60 th and following reports, until this one,
now at Internet.
To enable the understanding we excluded many statistical analysis, although their importance, because
they turned the already big and multiple tables no-understandable.
From that year on until now, we daily looked for other doctors studies and completed this portrait of
these disturbs, their etiologies, pathophysiologies, therapies, and included some of our typical patients.
We have corrected and amplified this e-book with other doctors findings near monthly. These more
than 750 doctors, here quoted, discovered much more than we did.
Our patients were Brazilian, mean age of 38.7 years, standard deviation of 18.4 years, gender female
= 772 (60.8%), male = 498 (39.2%), with all Brazilian ethnicities.
We systematically examined these patients by the following method:
III-2 – Anamnesis detailing the patient’s complaints. We ask to the patient his/her details about:
– Main occupation.
– Age.
– Eyeglasses already in use.
– Head's aching place: show with the finger. Time of aches beginning or on awakening? Duration.
Trigger. Other symptom?
– Eyes: itch, tearful, swell, redness.
– Rhinitis, sinusitis, sneezes, dry cough.
– Dizzy. Buzz. Hoarseness. Retching.
– Is taking some medication? Which one? Any sickness?
– Wine, beer? When and how much daily? Hangover on the next day?
– Coffee? When and how much daily?
– Tea? Which, when and how much daily?
– Cola, guaraná, other soft drink? Which, when and how much daily?
– Chocolate? When and how much daily?
– Water: how many glasses at morning, lunch, afternoon, dinner, before sleeping. Glasses size.
We classified our patients by the place that aches, other characteristics, and all etiologic possibilities.
We excluded from this statistic those patients with headaches secondary to sicknesses as infections, tumors,
trauma, hemorrhages, etc.
III-3 – Optic Nerve’s disk direct ophthalmoscopy (ocular fundus examination) in a dark room, with
red-free light in the direct ophthalmoscope, carefully registering subtle characteristics, as:
a- Optic Nerve’s cup/disk diameter ratio.
b- Cup deepness.
c- Laminar pores visualization at the cup’s bottom.
d- Minimal borders’ edema.
e- White sheaths around the arteries and veins at the Optic Nerve’s Disk.
We utilized the following Optic Nerve’s Cup/Disk scales, observed on direct ophthalmoscopy: