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

Fluids Hypertension Syndromes – Dr. Leonardo Izecksohn – page 92
There might be compensatory mechanisms that physiologically equalize the fluids’ pressures at both
sides of the Optic Nerve's Lamina Cribosa when necessary, but this pressures equalization is not instantaneous.
The equalization of the Cerebrospinal fluid pressure with the inner ear’s pressure is made
by the Ductus Endolymphaticus, which might be instantaneous. The Fluids Hypertension Syndromes at
the Optic Disk and Acoustic Nerve only happen because these compensatory pressures equalizer mechanisms
delay, were damaged and obstructed, or were supplanted.
When the Cerebrospinal fluid pressure is too much raised, it squeezes all the body’s nerves and they
suffer, their functions are disturbed, and they ache.
IX – B - Pathophysiology of the Lamina cribosa pores and Optic Nerve’s disk cup: When there is
an intraocular pressure higher than 16 mmHg or too much higher than the Cerebrospinal fluid pressure,
it squeezes the Optic Nerve’s Lamina Cribosa from inside the eye to the outside (to the Optic Nerve),
and it aches as Migraines and other alternative signs and symptoms. This same squeeze, when it is bigger
than the blood pressure in the arterial capillaries at the retina, or repeated hundreds of times, causes
the atrophy of the retinal ganglion cells and respective Optic Nerve’s fibers.
“In open-angle glaucoma with normal intraocular pressure, cerebrospinal fluid pressure is abnormally
low, leading to an abnormally high trans-lamina cribosa pressure difference. Pathogenetically, a
low cerebrospinal fluid pressure in normal intraocular pressure glaucoma may be similar to a high intraocular
pressure in high intraocular pressure glaucoma. Consequently, the glaucomatous visual field
defect is positively correlated with the trans-lamina cribosa pressure difference and inversely correlated
with the cerebrospinal fluid pressure. In nonglaucomatous subjects, cerebrospinal fluid pressure,
blood pressure and intraocular pressure are significantly associated with each other.”(Ren R, and others).
The progressive atrophy of the Optic Nerve fibers causes visible increasing cupping of this nerve, to
all directions: in diameter (horizontal, vertical or oblique), in deepness, and in visibility of the Lamina
Cribosa’s pores, and this is the glaucomatous damage or glaucomatous neuropathy. (Scheme IX-2).
Most of these changes of the Optic Nerve's cup are well known, but the Lamina Cribosa pores visibility
is not. The actual Optic Nerve’s photographic devices do not show well the pores, because the
Lamina Cribosa is 4 diopters far from the retinal focus plane. The nowadays best instrument to see the
Lamina Cribosa’s pores is the direct ophthalmoscope.