Revue médicale de Liège
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Chronic headaches due to intracranial hypo- or hypertension (IHS codes 7.2 and 7.1) may be difficult to diagnose. In this article, we review their principal clinical characteristics, etiologies and therapies. Intracranial hypotension may be caused by CSF linkage, e.g. after lumbar puncture. ⋯ Increased opening pressure of the CSF will confirm the diagnosis. Etiologies such as cerebral venous thrombosis, have to be excluded by adequate imaging methods. In both hypo- and hypertension syndromes, various therapeutic strategies have been proposed.
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The International Society of Hypertension and the World Health Organisation have recently published new guidelines for the management of hypertension. Epidemiologic studies have shown that management of hypertension still remains unsatisfactory. ⋯ The target blood pressure under treatment must be less than 140/90 mmHg, and even lower for diabetic or chronic renal failure patients. In parallel, all cardio-vascular risk factors have to be corrected to decrease the global cardio-vascular risk.