Temporal Arteritis

    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, temporal arteritis can occur in almost any medium to large artery in the body.

    Older individuals, over 60 years of age, are more likely than younger individuals to develop the condition. According to St. Luke’s Cataract and Laser Institute, women are almost four times as likely as men to develop temporal arteritis.

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

    If you think that you may have temporal arteritis, it is imperative that you go see a doctor as soon as possible. Temporal arteritis can cause very serious complications, but the risk of developing these complications can be reduced by seeking immediate medical attention and treatment.

    Symptoms of Temporal Arteritis

    Symptoms of temporal arteritis can include:

    • excessive sweating
    • disturbances in vision (blurred vision, double vision, reduced vision)
    • sudden, permanent loss of vision in one eye
    • throbbing headache (usually in the temples)
    • fatigue and weakness
    • general ill feeling
    • loss of appetite
    • muscle aches
    • transient jaw pain (this sometimes, but does not always, occur with chewing)
    • fever
    • unintentional weight loss
    • bleeding gums
    • facial pain
    • hearing loss
    • mouth sores
    • drooping eyelid
    • joint pain and stiffness
    • shoulder and hip pain and stiffness (While these symptoms are indicative of polymyalgia rheumatica, approximately 50 percent of patients with temporal arteritis also have polymyalgia rheumatica.)
    • depression
    • tenderness in the scalp and temple areas

    This list of symptoms isn’t completely fool-proof. On one hand, these symptoms can be signs of other conditions as well. On the other hand, some patients with temporal arteritis may exhibit only a persistent fever (and none of the other symptoms). Therefore, it is important to see your doctor for a thorough examination to obtain an accurate diagnosis.

    According to the National Institutes of Health, nearly 40 percent of affected individuals will also experience symptoms like nerve pain or respiratory problems (NIH, 2011).

    Diagnosis of Temporal Arteritis

    Your doctor will perform a physical exam, looking at your head to determine whether there is any tenderness. He or she will pay special attention to the arteries in your head. In addition, he or she may order a blood test. Several blood tests can be useful in diagnosing temporal arteritis. These include:

    • hemoglobin test: This test measures the amount of hemoglobin (oxygen-carrying protein) in your blood.
    • hematocrit test: This test measures the percentage of your blood that is made up of red blood cells.
    • liver function test
    • erythrocyte sedimentation rate (ESR) test: This test measures how quickly your red blood cells collect at the bottom of a test tube. A high ESR result shows inflammation in your body.
    • C-reactive protein test: This test measures the level of a protein found in your liver. Again, a high result indicates that there is inflammation in your body.

    Although these tests can be helpful, blood tests alone are not enough for a diagnosis. Usually, in order to make a definitive diagnosis, your doctor will perform a biopsy of the artery that he or she suspects is affected. This can be done as an outpatient procedure using local anesthesia. Other tests that your doctor may use to make a diagnosis include a computed tomography (CT) scan and magnetic resonance imaging (MRI).

    Treatment of Temporal Arteritis

    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 have not yet confirmed the diagnosis. This is because, if temporal arteritis is allowed to continue untreated, it can cause serious, potentially life-threatening complications. These complications include stroke, blindness, and aortic aneurysm. Aortic aneurysm can lead to massive internal bleeding and death.

    Therefore, if diagnosis is suspected and the results are pending, your doctor will prescribe oral corticosteroids. Your doctor may also recommend taking Aspirin to treat the musculoskeletal symptoms. The treatment typically lasts for one to two years. While you are undergoing corticosteroid therapy, it is important that you maintain a regular check-up schedule with your doctor. He or she will need to monitor your progress, as well as the way that your body is handling the drugs. 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

    Once you have finished your course of treatment, you will still need to see your doctor for checkups, because temporal arteritis can recur.

    Potential Complications of Temporal Arteritis

    Complications can occur as a result of both the condition itself and as a result of the oral corticosteroid treatment. If temporal arteritis is not treated, the following complications can occur:

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

    Corticosteroids can also cause complications. They can put users at a higher risk of developing certain medical conditions, such as osteoporosis, high blood pressure, muscle weakness, glaucoma, and cataracts. Other potential side effects of the medicines include:

    • weight gain
    • increased blood sugar levels (which can lead to diabetes)
    • thinning skin, increased bruising
    • decreased immune system function

    Talk with your doctor about ways to minimize any complications from the condition.