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Temporal arteritis

Temporal arteritis is inflammation and damage to the blood vessels that supply blood to the head.

If the inflammation affects the arteries in your neck, upper body and arms, it is called giant cell arteritis.

Alternative Names

Arteritis - temporal; Cranial arteritis; Giant cell arteritis

Causes, incidence, and risk factors

Temporal, giant cell, and cranial arteritis occur when one or more arteries become inflammed, swollen, and tender.

Temporal arteritis commonly occurs in the the arteries around the temples (temporal arteries). These vessels branch off from the carotid artery in the neck. However, the condition can occur in medium-to-large arteries in other places in the body.

The cause of the condition is unknown. It is believed to be due in part to a faulty immune response . The disorder has been linked to severe infections and the use of high doses of antibiotics.

The problem may develop with or following another inflammatory disorder known as polymyalgia rheumatica . Giant cell arteritis almost always occurs in people over age 50. It is rare in people of African descent. The condition may run in families.

Symptoms


  • Throbbing headache on one side of the head or the back of the head
  • Tenderness when touching the scalp

  • Excessive sweating
  • Fever
  • General ill feeling
  • Jaw pain that comes and goes or occurs when chewing
  • Loss of appetite
  • Muscle aches
  • Pain and stiffness in the neck, upper arms, shoulder, and hips
  • Weakness, excessive tiredness
  • Blurred vision
  • Double vision
  • Reduced vision (blindness in one or both eyes)

Other symptoms that may occur with this disease:


Signs and tests

The doctor will examine your head.

  • The scalp is often sensitive to touch
  • There may be a tender, thick artery on one side of the head, most often over one or both temples.

Blood tests may include:

Blood tests alone cannot provide a diagnosis. You will need to have a biopsy (tissue sample) from the involved artery.  The biopsy is done on an outpatient basis.

You may also have other tests, including:

Treatment

Receiving treatment right away is key to preventing severe problems such as blindness or even stroke.

Most of the time, you will receive corticosteroids medicines you take by mouth. These medicines are often started even before a biopsy is done. Your doctor may also tell you to take aspirin.

Most people begin to feel better within a few days after starting treatment. However, you will need to take medicine for 1 - 2 years. The dose of corticosteroids will be cut back very slowly.

Long-term treatment with corticosteroid medicines can make bones thinner and increase your chance of a fracture. You will need to take the following steps to protect your bone strength.

  • Avoid smoking and excess alcohol intake
  • Take extra calcium and vitamin D (based on your health care provider's advice)
  • Start walking or other forms of weight-bearing exercises
  • Have your bones checked with a bone mineral density (BMD) test or DEXA scan

You may also need to take other medications that suppress the immune system.

Expectations (prognosis)

Most people make a full recovery, but treatment may be needed for 1 to 2 years or longer. The condition may return at a later date.

Damage to other blood vessels in the body such as aneurysms (ballooning of the blood vessels) may occur. This damage can lead to a stroke in the future.

Calling your health care provider

Call your health care provider if you have a throbbing headache that does not go away, and other symptoms of temporal arteritis.

Prevention

There is no known prevention.

References

Hellmann DB. Giant cell arteritis, polymyalgia rheumatica, and Takayasu's arteritis. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Welley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2012:chap 88.

Updated: 2/6/2013

Matthew M. Cooper, MD, FACS, Medical Director, Cardiovascular Surgery, HealthEast Care System, St. Paul, MN. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.


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