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

Fluids Hypertension Syndromes – Dr. Leonardo Izecksohn – page 94
We conclude that the pores visibility of the Lamina cribosa in the Optic Nerve’s cup bottom is
evidence of damage of this nerve’s fibers caused by the pathological rise of the intraocular pressure,
repeated during months or years, and they are felt as Migraines. This association of migraines
with visibility of Lamina Cribosa’s pores is a diagnosis of the Glaucoma slowly progressing.
Meanwhile, these patients also can have simultaneously the other two Fluids Hypertension Syndromes.
We found that from the 388 patients with visibility of their Lamina Cribosa pores, only 16,2% with
high (22 mmHg or more) intraocular pressure at the office exams.
We conclude that 83,8% of patients with visibility of the Lamina Cribosa pores suffer from high
intraocular pressures at other hours far from the medical office.
- Migraines, excessive water and Normal tension glaucoma: On the year 1999, we had a 33-yearold
patient, mathematic teacher, Brazilian white, no child, 1.66 meters (5 feet and 5 inches) tall, 60
Kilograms (132 pounds) of weight. She was myopic of 3.50 diopters at both eyes and needed eyeglasses
and contact lenses. On direct ophthalmoscopy we found Optic Nerve’s cups of 0.6/2/1/0 (cupdisk
diameter/ cup depth/ lamina cribosa’s pores visibility/ borders edema). Her intraocular pressures
were 12 and 12 mmHg in both eyes, physiologic anterior chambers, and she complained about nothing.
On the year 2000, she came for another eyeglass, and we found her Optic Nerve’s cups of 0.6/3/1/0 in
both eyes.
On the year of 2002, she came again and this time she told us that she was suffering from daily frontal
headaches at awakening for the last four years, without diagnosis. This time she told us about drinking
“too much water daily”, and we prescribed her to shorten this excessive water. All the rest of the
examination was equal to the anterior.
She came again on the year 2007, complaining of left temporal headache at awakening, both eyes
itching, tearfulness, and obstructive rhinitis. We found on direct ophthalmoscopy the Optic Nerve’s
cups of 0.7/4/2/0 and 0.6/4/2/0 right and left eyes, which is a significant progression of this Normal
(Peak) Tension Glaucoma. She was drinking daily 19 glasses off water of 300 milliliter each, totalizing
5,700 milliliter daily (one and a half gallon), because she felt the mouth dry. The intraocular pressures
on applanation tonometry at the office still show 12 and 12 mmHg in both eyes, which is physiologic.
Nobody knows her intraocular pressures after drinking plenty of water and when sleeping.
This is a good example of a progressive Normal (Peak) Tension Glaucoma and respective Migraines
and variants, caused only by daily excessive water drank during many continual years.
IX - C – We had 388 patients with some visibility of the Lamina Cribosa's Pores (grades 1 to 3) in
at least one eye, at the bottom of their Optic Nerves’ cups. Grade 0 is no visibility.
These 388 patients presented at their worst eye:
- 192 patients (49.5%) with visibility grade 1 (feebly visible);
- 151 patients (38.9%) with visibility grade 2 (well visible);
- 45 patients (11.6%) with visibility grade 3 (perfectly visible).
- These 388 patients with some visibility of their Lamina Cribosa's pores, presented:
- 314 patients (80.9%) with some Migraine, or any other sign or symptom;
- 137 patients (35.3%) with wide frontal Migraines;
- 102 patients (26.3%) had their Migraines worsened at morning;
- 87 patients (22.4%) with tearfulness and rhinitis;
- 81 patients (20.3%) with itching eyes or blepharitis;
- 74 patients (19.1%) without any Migraine, sign or symptom;
- 65 patients (16.8%) with ocular Migraines or aches;
- 35 women (15.6% out of the 225 women) with menstrual migraines;