Inflammation of the blood vessels around the head and scalp
- Rare under the age of 55; increasingly common with age
- More common in females
- Sometimes runs in families; more common in white people
- Lifestyle is not a significant factor
In giant cell arteritis, also called temporal arteritis, particular arteries become inflamed and narrowed, reducing the blood flow through them. The disorder mainly affects blood vessels in the head and scalp, such as the temporal arteries (the arteries on the sides of the forehead). In some cases, the arteries that supply blood to the eyes are affected.
The cause of giant cell arteritis is not known, but it may be due to an autoimmune reaction in which the immune system attacks the arteries. Giant cell arteritis may occur with polymyalgia rheumatica, may sometimes run in families (suggesting that genetic factors may be involved), and is more common in women and older people.
What are the symptoms?
If you have giant cell arteritis, you may notice the following symptoms:
Severe headaches affecting either one or both sides of the head.
Tenderness of the scalp.
Pain in the sides of the face, which becomes worse on chewing.
Prominent, tender temporal arteries.
Loss of appetite and weight loss.
These symptoms may be accompanied by those of polymyalgia rheumatica, such as pain and stiffness in the muscles of the shoulders and hips. In rare cases, a stroke may occur. If you also develop visual disturbances, you should consult your doctor at once because untreated giant cell arteritis can lead to loss of an area of vision or even blindness.
What might be done?
Your doctor may be able to diagnose giant cell arteritis from your description of the headache and by a physical examination. He or she may arrange for an urgent blood test to look for inflammation. You may also have a biopsy of the temporal artery, in which a tissue sample is taken for examination.
To reduce inflammation, a high dose of an oral corticosteroid will be prescribed immediately. The symptoms of giant cell arteritis usually improve within 24 hours of starting treatment. Once the condition improves, the initial high dose of corticosteroid will be reduced, but you may need to continue taking smaller doses for 2–3 years.
Your doctor will probably recommend that you have regular blood tests to monitor the course of the disorder. He or she may prescribe an immunosuppressant as an alternative drug if there is little or no improvement in your condition or if you develop side effects with the corticosteroid.
What is the prognosis?
In some cases, giant cell arteritis may clear up completely with treatment, but in other cases the symptoms may recur. If you already have vision impairment due to giant cell arteritis, your sight may not improve with treatment. However, it may be possible to prevent further deterioration of your vision.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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