Temporal Arteritis: Symptoms, Diagnosis, and Treatment
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Temporal Arteritis

Temporal arteritis

Highlights

  1. Nearly one-quarter million people in the United States have temporal arteritis.
  2. Temporal arteritis is almost nonexistent in people under the age of 50.
  3. Untreated temporal arteritis can lead to other serious conditions, including aneurysms, strokes, and even death.

Temporal arteritis is a condition in which the temporal arteries, which supply blood to the head and brain, become inflamed or damaged. It is also known as cranial arteritis or giant cell arteritis. Although this condition usually occurs in the temporal arteries, it can occur in almost any medium to large artery in the body.

The journal Arthritis & Rheumatology states that approximately 228,000 people in the United States are affected by temporal arteritis. According to the American College of Rheumatology, people over the age of 50 are more likely than younger people to develop the condition. Women are also more likely than men to have temporal arteritis. It is most prevalent in people of northern European or Scandinavian descent.

Although the exact cause of the condition is unknown, it may be linked to the body’s autoimmune response. Also, excessive doses of antibiotics and certain severe infections have been linked to temporal arteritis. There’s no known prevention. However, once diagnosed, temporal arteritis can be treated to minimize complications.

If you think that you may have temporal arteritis, you should see a doctor as soon as possible. Temporal arteritis can cause very serious complications, but seeking immediate medical attention and treatment can reduce the risk of developing these complications.

Symptoms of temporal arteritis

Symptoms

The symptoms of temporal arteritis can include:

  • double vision
  • sudden, permanent loss of vision in one eye
  • a throbbing headache that’s usually in the temples
  • fatigue
  • weakness
  • loss of appetite
  • jaw pain, which sometimes can occur with chewing
  • fever
  • unintentional weight loss
  • shoulder pain, hip pain, and stiffness
  • tenderness in the scalp and temple areas

These symptoms can also occur due to other conditions. You should call your doctor anytime you’re worried about any symptoms you’re experiencing.

Diagnosis of temporal arteritis

Diagnosis

Your doctor will perform a physical exam and look at your head to determine whether there’s any tenderness. They’ll pay special attention to the arteries in your head. They may also order a blood test. Several blood tests can be useful in diagnosing temporal arteritis, including the following:

  • A hemoglobin test measures the amount of hemoglobin, or oxygen-carrying protein, in your blood.
  • A hematocrit test measures the percentage of your blood that is made up of red blood cells.
  • A liver function test can be done to determine how well the liver is working.
  • An erythrocyte sedimentation rate (ESR) test measures how quickly your red blood cells collect at the bottom of a test tube over one hour. A high ESR result means that there’s inflammation in your body.
  • A C-reactive protein test measures the level of a protein, made by your liver, that’s released into your bloodstream after tissue injury. A high result indicates that there’s inflammation in your body.

Although these tests can be helpful, blood tests alone aren’t enough for a diagnosis. Usually, your doctor will perform a biopsy of the artery that they suspect is affected to make a definitive diagnosis. This can be done as an outpatient procedure using local anesthesia. An ultrasound may provide an additional clue about whether or not you have temporal arteritis. CT and MRI scans are often not helpful.

Potential complications of temporal arteritis

Complications Icon

If temporal arteritis isn’t treated, serious, potentially life-threatening complications can occur. They include:

  • inflammation and damage to other blood vessels in the body
  • development of aneurysms, including aortic aneurysms
  • vision loss
  • eye muscle weakness
  • blindness
  • stroke

An aortic aneurysm can lead to massive internal bleeding. Death can also occur if temporal arteritis isn’t treated. Talk with your doctor about ways to minimize any complications from the condition.

Treatment of temporal arteritis

Treatment

Temporal arteritis cannot be cured. Therefore, the goal of treatment is to minimize tissue damage that can occur due to inadequate blood flow caused by the condition.

If temporal arteritis is suspected, treatment should begin immediately, even if test results haven’t yet confirmed the diagnosis. If this diagnosis is suspected and the results are pending, your doctor may prescribe oral corticosteroids. Corticosteroids can increase your risk of developing certain medical conditions, such as:

  • osteoporosis
  • high blood pressure
  • muscle weakness
  • glaucoma
  • cataracts

Other potential side effects of the medicines include:

  • weight gain
  • increased blood sugar levels
  • thinning skin
  • increased bruising
  • decreased immune system function
  • difficulty sleeping at night and restlessness

Talk with your doctor about ways to minimize these side effects.

Your doctor may also recommend taking aspirin to treat the musculoskeletal symptoms.

Treatment typically lasts for one to two years. While you’re undergoing corticosteroid therapy, it’s important that you have regular checkups with your doctor. They’ll need to monitor your progress, as well as the way that your body is handling medical treatment. Prolonged use of corticosteroids can have detrimental effects on your bones and other metabolic functions.

The following measures are generally recommended as part of treatment:

  • taking a calcium and vitamin D supplement
  • quitting smoking
  • doing weight-bearing exercise, like walking
  • getting regular bone density screenings
  • getting occasional blood sugar checks

You’ll still need to see your doctor for checkups once you’ve finished your course of treatment. This is because temporal arteritis can recur.

What is the outlook for people with temporal arteritis?

Outlook

Your outlook for temporal arteritis will depend on how quickly you’re diagnosed and able to start treatment. Untreated temporal arteritis can cause serious damage to the blood vessels in your body. Call your doctor if you notice new symptoms. This will make it more likely that you’ll be diagnosed with a condition when it’s in the early stages. 

Q&A

You Asked, We Answered

  • What is polymyalgia rheumatic, and how is it related to temporal arteritis?
  • Polymyalgia rheumatica (PMR) is a condition that occurs in women more than men, who are usually in their 70s. The condition involves muscle discomfort, soreness, and stiffness in the neck, shoulders, upper arms, hips, and upper thighs. The cause of PMR is unknown but it’s sometimes related to a viral illness that may cause the immune system to increase inflammation. There are some people who’ll have temporal arteritis and also develop symptoms of PMR, and how and why the two conditions overlap is unknown. Both conditions respond to oral steroids. It is estimated that roughly 711,000 people have PMR and 228,000 have temporal arteritis.  

    - Modern Weng, D.O.

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