This article discusses the impact of hypertension and hypotension on cerebral hemodynamics and brain damage. It emphasizes the importance of considering blood pressure variables, such as variability and circadian rhythm, in addition to achieving target blood pressure levels for optimal brain protection. The article also highlights the challenges in treating cerebral hemodynamics due to the different compartments in the brain and the damage that may already be present. It emphasizes the need for early detection of silent brain damage and the potential role of 24-hour ambulatory blood pressure monitoring in identifying and preventing cerebrovascular disease. [Extracted from the article]