11. DSA: Head Pain and Venous Sinus Technique Flashcards
How can occipitomastoid compression contribute to sinus congestion?
It results in reduced venous drainage through the jugular foramen
-producing dysfunction of cortex, thalamus, hypothalamus, CN 9 and 10
Explain the trigeminal vascular reflex
- Pain fibers from cortex, thalamus, and hypothalamus send impulses through CN 7
- Impulses cause PSym dilation of carotids
- Vasodilation of Internal Carotid stimulates trigeminal ganglion
- =edema in dura
After CN V1 is stimulated, neuropeptides are released which cause what?
Sterile inflammation
Leading to platelet aggregation and 5HT release
-may potentiate migraine process
Why is neck pain often involved in headpain/congestion?
CN V sends impulses to upper cervical cord of neck
What causes the migraine associated symptoms?
activation of CN V leads to activated brainstem reflexes
What does PSym activation of facial nerve cause?
Nasal congestion, rhinorrhea, and lacrimation
Breakdown of what monoamine is found in the urine of those who just had a migraine?
Serotonin
How does somatic dysfunction of upper thoracic spine contribute to migraine?
Increases Sym,
Which leads to vasoconstriction of vessels and decreases cerebral blood flow AKA ANOXIA
-anoxia (low O2) will cause vasodilation and contribute to migraine symptoms
Torsion of the sphenoid bone causes irritation of what nerve?
What does this cause?
Trigeminal nerve
-can trigger trigeminal vascular reflex
Sphenosquamous compression can cause compromise of which artery?
Middle meningeal
PARIETAL BONE
Internal rotation of temporal bone can result in what?
Reflex Vasodilation of Internal and External Carotid Arteries via the facial nerve
Somatic dysfunction of which synchondrosis is common in migraine?
Sphenobasilar synchondrosis
Treffer states multiple times that pain from migraines is usually caused by the ________ system?
Trigeminovascular
Maybe know this, but who knows.
What area of the body is most important for draining congestion from the head area?
Thoracic inlet!
Venous sinus drainage is part of which biomechanical model?
Resp/Circ
-slide 11
What channels on the feet of astrocytes facilitate the movement of CSF seen in the “glymphatic” system
Aquaporin 4 channels
also a quiz Q, may be on the exam
After draining from the aquaporin 4 channels into the paravenous sinuses, where does the lymph drain next?
Cervical lymphatic channels
Does the glymphatic system replace the CSF it reabsorbs?
nope
-accelerates the loss of waste products
Dysfunction of the glymphatic system may result in what neurodegenerative disease?
Alzheimers + others
What type of techniques seem to help during an acute attack of migraine?
Indirect with venous and lymphatic techniques
What are the absolute contraindications for venous sinus techniques?
Skull fractures
Acute CVAs
Intracranial bleeds
Cranial Infection
SAIC
What are the relative contraindications for venous sinus techniques?
Coagulopathies
Acute concussion
Increased intracranial pressure
Space Occupying lesions
What are the three dural folds?
Falx Cerebri
Tentorium Cerebelli
Falx Cerebelli
What is the reciprical tension membrane?
It is a unit of function between the spinal and cranial dura that applies a constant tension
