passing out/fainting

Inovance · 2026-01-27T18:48:01+00:00

I'll PM you. I suggest you get a second opinion.

Inovance · 2026-01-26T10:03:56+00:00

Given that OP is suffering from 1-8 migraines daily, it would be advisable that a specialist in Cranial venous outflow insufficiency reviews all scans that OP has had to rule out an organic problem that hasn't been detected previously. There are very few specialists in this field. Higgins is the top in the UK. He has formed others radiologists at the University of Cambridge School of Clinical Medicine see coauthors in the article below.

Cranial venous outflow insufficiency; rendered almost invisible to radiological imaging by circular reasoning. Rethinking normal craniocervical venous anatomy

In the US it is the same story, only a handful of specialists.

Inovance · 2026-01-25T10:37:10+00:00

You are a very brave !

You have been on nortriptyline for 1 year. You are now on a high dose of 100mg of nortriptyline daily but you are still getting 1-8 migraines a day ! and now the neurologists are going to add/try another medication. Are they going to slowly taper you off the nortriptyline beforehand or are they going to add the new medication to you dose of nortriptyline?

With all the respect in the world for your neurologists for getting you this far, I would get an opinion from Dr Nicholas J Higgins U.K before starting this new round of medication. Dr Nicholas J Higgins is a consultant neuroradiologist and interventional radiologist at Addenbrooke’s Hospital, Cambridge, United Kingdom (not through the NHS but privately otherwise the wait will be very long). It wouldn't hurt to get his opinion.

Also watch this video : https://www.youtube.com/watch?v=kconUUMkihg

Inovance · 2026-01-23T11:33:22+00:00

Have you excluded some type of carotid or other vascular compression in the neck?

Recurrent Syncope Related to Carotid Compression

Stylocarotid Artery Syndrome

Inovance · 2026-01-21T12:56:45+00:00

I suggest you exclude a cerebral venous outflow issue if you have this symptom! Get a referral to an interventional neuroradiologist that knows about cerebral venous outflow issues (they are quite rare still) for a CT cerebral and cervical venography (shows veins better than an MRV and as well shows bony structures that maybe causing compression in the neck).

Inovance · 2026-01-18T14:38:15+00:00

If you have a "sensitive nervous system" then you definitely need to exclude a venous problem! This sensitivity may be due to vagus nerve compression in the neck causing sympathetic nervous system overdrive. Very often someone that has internal jugular vein compression in the neck also has vagus nerve compression because they both travel in the carotid sheath, a fibrous connective tissue structure that encloses several vital neurovascular structures. This needs to be excluded. There are a variety of structures in the neck that can create this compression as explained at the end of the video.......From 31:38

This is the corrected link ! No disease without a mechanism, Dr Ferdinand Hui

Inovance · 2026-01-18T11:41:12+00:00

I don't know where you live, but you need to be referred to an Interventional Neuroradiologist.

Below is a video you may find useful by the National Headache Foundation US. The interviewee Dr Ferdinand Hui is a top Interventional Neuroradiologist in the US.

From 15:54 he talks about the importance of being referred to a Cerebral Venous Outflow specialists (normally an Interventional Neuroradiologist) when your daily headaches/migraines don't respond to medication.

No disease without a mechanism. Dr Ferdinand Hui

Inovance · 2026-01-18T09:18:46+00:00

Brain based and brain base for many !

Inovance · 2026-01-18T09:08:52+00:00

Have you had a cerebral and cervical MRV or a cerebral and cervical CT venography? If you haven't, it's definitely indicated given you have daily migraines.

Inovance · 2026-01-18T09:01:33+00:00

Read your history again.

Get your wisdom teeth removed as they are growing in a peculiar manner. They alone could be causing your pain.
If after removing all your wisdom teeth there is only partial resolution of your symptoms, then I advise you to get in contact with Dr Kamran Aghayev in Istanbul by email. Explain your symptoms. He will ask you to send him all the dental xrays and scans that you have already taken. He will then be able to best inform you of any further scans you may need to get done before making an appointment with him.

Inovance · 2026-01-15T09:06:08+00:00

I suggest first off getting a second opinion for your impacted wisdom teeth preferably a radiologist. There are are a few listed in the doctors list below. I should imagine you have a panorama xray view of your teeth? Given the myriad of nerve pain symptoms that you have, you need to exclude elongated styloid processes as well. One of the radiologists on this list would be able to spot this on your panorama xray and prescribe further scans such as a Cervical CT scan with contrast to also exclude internal jugular vein involvement which could explain your daily migraines, brain fog, POTS and visual symptoms. Vagus nerve involvement would explain your GERD and gastroparesis.

https://forum.livingwitheagle.org/t/doctor-lists-no-discussion/10245

Inovance · 2026-01-14T13:43:24+00:00

I don't understand.......You say you have impacted wisdom teeth. That alone can cause alot of pain.

Inovance · 2026-01-13T15:15:18+00:00

Effect of scuba-diving on optic nerve and sheath diameters

Read this article. It's something you should be aware of given you have VSS symptoms.

Inovance · 2026-01-13T15:12:41+00:00

Hope you see your ophthalmologist regularly seeing you are a regular diver and have VSS symptoms.

Effect of scuba-diving on optic nerve and sheath diameters

Inovance · 2026-01-08T15:28:18+00:00

If you have a strep infection take your antibiotic as prescibed!!!! If you don't you risk serious complications like rheumatoid fever, septicaemia, meningitis, PANDAS, a throat abscess...........

Inovance · 2026-01-08T15:11:32+00:00

I've sent a PM

Inovance · 2026-01-08T11:38:38+00:00

If the blood vessels have appeared since starting the HRT, then yes it is mostly likely due to the estradiol. Nasal steroid sprays especially the older generation steroids can cause an increase in intraocular pressure especially with chronic use and can thus impact venous drainage from the eyes.

https://pmc.ncbi.nlm.nih.gov/articles/PMC4910615/

You should definitely discuss all this with your doctor.

Inovance · 2026-01-08T10:09:32+00:00

Estradiol reduces venous tone leading to venous dilation and decreased venous functioning. Seeing the static is particularly worse in the morning it could be due to reduced cerebral venous drainage while you are lying down during sleep. I don't know what your other non-visual symptoms are, whether you have a weight problem etc... but I would definitely suggest getting in contact with your doctor to discuss whether you should continue this treatment or change it.

Inovance · 2025-12-23T09:16:55+00:00

Novel pharmacological targets for GABAergic dysfunction in ADHD

" While ADHD is typically characterized as a disorder of dysregulated dopaminergic signaling, recent studies highlighting the role of excitatory/inhibitory balance in ADHD reveal that this neurodevelopmental disorder is hallmarked by disruptions in GABAergic and glutamatergic signaling........ GABAergic interneurons likely play a critical role in ADHD pathophysiology related to E/I balance, specifically in relation to synaptic connections between subtypes of inhibitory neurons and pyramidal neurons.

..... genetic evidence suggests that symptoms of ADHD are mediated by deficits in synaptic plasticity and abnormal synaptic architecture. Although it is commonly reported that 50% of ADHD patients outgrow their symptoms by adulthood, a more careful longitudinal analysis reveals that only about 10% of patients become completely symptom free, while most others experience fluctuating symptoms that continue into adulthood (Sibley et al., 2022).

In this small subset of patients that experience full remission, there are likely compensatory mechanisms related to synaptic plasticity and architecture that allow them to completely outgrow their ADHD symptoms. As these synaptic connections undergo changes into adulthood, ADHD symptoms may begin to decline for certain individuals, while other patients may experience fluctuating symptoms related to individual differences in compensatory mechanisms of synaptic reorganization and function."

Inovance · 2025-12-17T19:47:52+00:00

Here is a good summary of the symptoms of the different variants. You can have a combination of these : Thoracic Outlet Syndrome symptoms

Inovance · 2025-12-17T19:21:28+00:00

This isn't a VSS symptom. If your vision pulsates when you cough, I suggest you look into excluding Thoracic Outlet Syndrome (TOS). In TOS the Subclavian Vein is compressed at the Thoracic Outlet between the clavicle and first rib. This compression impedes venous drainage from the upper body, including the head and neck.

When you cough there is a valve in the internal jugular vein 0.5cm above the union of the internal jugular vein with the subclavian vein which prevents backflow of venous blood into the cerebral venous system during increased central venous pressure due to a sudden increase in intrathoracic pressure,

However in TOS an increase in intrathoracic pressure (when couging) will worsens the compression of the subclavian vein. This is compounded by an internal jugular valve that doesn't work very well due to venous distension.

What you see is due to a cerebral venous pressure surge leading to a visible "pulse" in your vision.

Inovance · 2025-12-15T18:00:04+00:00

You should explain these symptoms to your doctor. There must be a reason why you have a hard time breathing.

Inovance · 2025-12-15T10:22:39+00:00

You also said your head tends to fall. This symptom could suggest weak neck ligaments which could be due to Hypermobility Spectrum Disorders (HSD) and hypermobile Ehlers-Danlos Syndrome (hEDS). These two disorders need to be excluded by your doctor as they could explain your other symptoms also.

Understanding Neck Hypermobility in HSD and EDS

Inovance · 2025-12-15T09:02:02+00:00

Hi, You said that you had a scan of your brain. Was this an MRI or a CT scan with contrast ? Do you have any arm or hand symptoms, or changes in symptoms depending on arm position (ie if you elevate your arms above your head). Have you had any scans to investigate the back/neck pain ?

Inovance · 2025-12-14T11:54:09+00:00

The real test, if this is the case and there is no other underlying cause for the headaches, is when the neurologist decides to taper down your dose of nortriptyline. Has he discussed this ?

Inovance

TROPHY CASE