Temporal, or giant cell, arteritis is a condition affecting older people characterized by inflammation of arteries in the head and neck. Inflammation leads to swelling and scarring of the blood vessel walls, interfering with the blood supply to surrounding tissues. This lack of blood flow results in a variety of symptoms, including headache and other pains. The cause of temporal arteritis is not known.
The Disease
Temporal arteritis is most common in individuals over age 60 and affects women more often than men, according to "Sternberg's Diagnostic Surgical Pathology." The arteries of the head, neck or upper body are usually involved, most frequently the temporal arteries in front of and above the ears. Patchy areas of inflammation and swelling in the blood vessel walls cause irregular narrowing of the central channel, blocking the normal flow of blood. Symptoms are caused by insufficient blood and oxygen reaching the muscles or organs fed by these arteries.
Common Symptoms
Headache is the most common symptom of temporal arteritis. The headaches are often severe and throbbing, most frequently involving the temples. Other regions of the head may also be involved. The area of the temporal arteries may be tender and feel bumpy when touched. Pain of the face, tongue or throat can occur, as well as jaw pain when chewing or scalp pain when using a hairbrush. Whole body symptoms such as fatigue, weight loss, poor appetite and fever are common.
Severe Symptoms
Involvement of the arteries supplying blood to one or both eyes can lead to sudden and irreversible blindness, according to the Merck Manual. Other visual symptoms include double vision, spots before the eyes or blurred vision. These may occur on their own or precede vision loss, and they should be immediately reported to a health care practitioner in cases of suspected temporal arteritis. Other uncommon severe symptoms include stroke when brain arteries are involved, and chest or arm pain with involvement of the aorta.
Polymyalgia Rheumatica
Approximately half the people who develop temporal arteritis will also have symptoms of polymyalgia rheumatica, either at the same time or prior to their arteritis, as discussed on FamilyDoctor.org, a website from the American Academy of Family Physicians. Polymyalgia rheumatica is an inflammatory condition of unknown cause, involving the muscles of the neck, shoulders, hips and thighs. Its symptoms include muscle aches and pains, weakness, fatigue and weight loss.
Diagnosis and Treatment
No specific blood test is available to diagnose temporal arteritis. When temporal arteritis is suspected, an erythrocyte sedimentation rate is ordered and is usually elevated. A biopsy of one of the temporal arteries may be obtained to look for inflammation. If the diagnosis is highly suspected or confirmed, treatment with steroids should be started immediately. Treatment should both prevent vision loss and reduce other symptoms relatively quickly.
References
- "Sternberg's Diagnostic Surgical Pathology", Fourth Edition; Stacey E. Mills M.D., Senior Editor, 2004.
- American College of Rheumatology: Giant Cell Arteritis.
- Merck Manual: Giant Cell Arteritis.
- FamilyDoctor.org: Giant Cell Arteritis and Polymyalgia Rheumatica
