Temporal Arteritis (Giant Cell Arteritis)

Overview

Temporal arteritis, also known as giant cell arteritis (GCA), is an inflammatory condition that primarily affects the medium- and large-sized arteries in the blood stream. The most commonly affected blood vessels are those of the head, eyes, and optic nerve. The term “temporal” stems from the fact that the temporal artery (the blood vessel that runs below the skin of the temple) often becomes swollen and prominent as a result of disease. The temple area also becomes tender and sometimes painful.

Swelling of the blood vessels leads to a reduction in blood flow and eventually a blockage. If blood is prevented from getting to particular tissues (such as the eye), the cells downstream of the blockage are starved for oxygen and nutrients and will soon die. Temporary loss of vision can be a critical sign of temporal arteritis and should prompt anyone who experiences it to see their doctor right away.

Temporal arteritis is a sight-threatening eye disease, but with prompt treatment with steroid medication, permanent vision loss can be prevented.

Signs & Symptoms of Temporal Arteritis

One of the most prominent of symptoms is a headache. Scalp tenderness is another hallmark of temporal arteritis – for example, it might become painful to comb the hair or to wear a hat. Pain may also occur in the temple area. Further symptoms include the following:

transient blurred vision
temporary loss of vision
loss of appetite
fever
fatigue
depression
drooping eyelid (ptosis)
sore neck
jaw pain
general ill-feeling
muscle aches

Detection & Diagnosis of Temporal Arteritis

An erythrocyte sedimentation rate (ESR) test is ordered when a person is suspected of having temporal arteritis. A blood sample is taken and spun in a centrifuge, forcing the red blood cells and all other blood cells to settle on the bottom. The sediment layer of red blood cells is then measured and compared against a normal value. An abnormally high sediment layer is indicative of an inflammatory process occurring (such as temporal arteritis).

The only truly conclusive test of temporal arteritis is a biopsy of the temporal artery. A small section of the temporal artery is removed while the patient is under local anesthesia. Once removed, the artery is examined under microscope for swelling of the blood vessel walls.

Temporal Arteritis Treatment

Treatment for temporal arteritis involves short-term steroid medication. The ophthalmologist works in conjunction with an internist to monitor the disease over time. While for most patients, only short term steroids are needed, some people may require long-term use of steroids.

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