Temporal arteritis overview
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Diagnosis |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Temporal arteritis is an inflammatory disease of blood vessels (most commonly large and medium arteries of the head). It is therefore a form of vasculitis. The name comes from the most frequently involved vessel (temporal artery which branches from the external carotid artery of the neck). The alternative name (giant cell arteritis) reflects the type of inflammatory cell that is involved (as seen on biopsy).
Historical Perspective
The disease was first described in 1890 by Hutchinson. The histopathology of the disorder was first described in 1932 by Horton. Visual loss was first reported by Jennings in 1938. Birkhead first described the use of steroids to prevent progression to blindness.
Diagnosis
Laboratory Findings
The sedimentation rate is very high in most of the patients, but may be normal in approximately 20% of the cases.
CT
Contrast enhanced brain CT is generally negative in this disorder.
MRI
Contrast enhanced brain MRI is generally negative in this disorder.
Ultrasound
Radiological examination of the temporal artery with ultrasound yields a halo sign.
Other Diagnostic Studies
The gold standard for diagnosing temporal arteritis is biopsy, which involves removing of a small part of the vessel and examining it microscopically for giant cells infiltrating the tissue. Since the blood 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.
Treatment
Primary Prevention
There is no known prevention for temporal arteritis.