Temporal arteritis

Temporal arteritis is the inflammatory disease of blood vessels (most commonly large and medium blood vessels of the head). The name comes from the most frequently involved vessel (temporal artery which branches from the external carotid[?] artery of the neck) and it is also named as giant cell vasculitis, indicating the type of cells infiltrating and damaging the vessels.

The disorder may coexist (in one quarter of cases) with another disorder called polymyalgia rheumatica[?], which is characterized by sudden onset of pain and stiffness in large joints (pelvis, shoulder[?]) of the body and seen in the elderly. Other diseases related with temporal arteritis are systemic lupus erythematosus, rheumatoid arteritis[?] and severe infections.

Temporal arteritis is more common in females and after 50 years of age. Patients present with fever, headache, tenderness and sensitivity on the scalp[?] and recurrent jaw pain evoked especially by chewing. Most importantly, the inflammation may affect blood suply to the structures providing vision, and blurred vision or blindness may occur, accordingly. Palpation of the head reveals sensitive and thick arteries with or without pulsation. Sedimentation rate is very high in most of the patients (may be normal in approximately 20% of cases). The inflammation of the vessel must be demonstrated by removing a small part of the vessel (biopsy[?]) and analysing it for giant cells infiltrating the tissue. Since the vessels are involved in a patchy pattern, there may be unaffected areas on the vessel and the biopsy might have been taken from these parts. So, a negative result does not definitely rule out the diagnosis.

Loss of vision of both eyes may occur very abruptly and this disease is therefore an emergency. Corticosteroids must be started as soon as the diagnosis is suspected (even before the diagnosis is confirmed by biopsy).