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

Fluids Hypertension Syndromes – Dr. Leonardo Izecksohn – page 34
This is a dangerous situation which can cause many definitive and serious damage to this patient, all
caused by the Cerebrospinal Fluid Hypertension Syndrome. They are listed above at the Summary.
In this E-book we study the very common small Cerebrospinal Fluid Hypertension, and not the rare
giant Papilledema.
III-4 – Ocular applanation (Goldmann) tonometry. We ever measure the intraocular pressure with
the patient on a sitting position at the slit-lamp, quietly, with one drop of anesthetic (Proximetacaine
cloridrate) eye drop, Fluorescein at the tip of the tonometer, and gentle relief of both eyelids’ pressures
from over the eyes. The upper eyelid is held by the first and the second fingers, and the inferior eyelid
is held by the fourth finger, without any pressure on the eye. The third finger rests my hand on the patient's
front or on the slit-lamp's front rest. The patient must be confident, because if he is stressed the
contraction of the extra-ocular muscles can cause a false rise in his intraocular pressure.
When there is marked intraocular pressures oscillation consequent to the cardiac pulse, we utilize the
higher value. We considered as physiologic the intraocular pressure from 10 up to 16 mmHg.
“Attempted forced eyelid closure is a common and statistically significant source of error in routine
outpatient measurement of intraocular pressure and could influence clinical management of glaucoma.”
(Gandhi P D, and others).
Scheme III-7: The true intraocular pressure is measured with the Goldmann applanation tonometer tip
only touching the cornea. The eyelids can not contact with the eye or with the tonometer tip. The fingers
can not pressure the eye.
III-5 – Ocular refraction and other exams when necessary.
IV) – Description of Migraines; distribution of Migraines, Benign Intracranial Hypertension
and Glaucoma by gender and age:
IV-a- Description: From 1,270 consecutively examined ophthalmological patients, 931 (73.7%) complained
of recurrent or continuous headaches, migraines or other interchangeable signs and symptoms
or migraine variants On their first exam. The aching sites were alternatively at the frontal, occipital,
temporal, posterior neck location, diffuse, or as an ocular ache, on the nose, ears, or rarely on the maxilla
or mandible.