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Giant Cell Arteritis

The disease, Giant Cell Arteritis, is an inflammatory disease of the blood vessels and involves the lining of the arteries, commonly involving the large and medium arteries of the head. The cause is unknown. When Giant Cell Arteritis involves the temporal artery, it is known as “temporal arteritis.” It primarily occurs in people aged 55 and above, more commonly in females, and usually involves the temporal artery (or the artery that supplies blood to the skin on the side of the forehead), although other arteries may be affected as well. The name “giant cell arteritis” is derived from the fact that “giant cells” develop in the walls of the inflamed arteries.

What are the symptoms of giant cell arteritis?

The symptoms of giant cell arteritis vary according to which artery is affected. The most common complaint is headache, which is often characterized as acute and severe in nature. Most patients even describe such symptoms as something they have never had. The pain may be unilateral or bilateral, but for some, the entire head becomes involved. Another common symptom experienced by the patient is the so-called Polymyalgia Rheumatica (PMR), or the aching and stiffness of the muscles on the neck, shoulders, upper arms, and hips, which occurs due to decreased blood supply and inflammation in these areas. Other symptoms of giant cell arteritis include fever, malaise, depression, loss of appetite (leading to weight loss), jaw claudication (aching of the jaw muscles while chewing or talking), visual disturbances (often one of the very first symptoms of the disease), and tenderness of the temporal artery.

In severe cases, such as in the complete blockage of the ophthalmic artery, permanent blindness of one or both eyes may result. Once this happens, there’s only a very little chance of recovery of vision, regardless if the patient is undergoing treatment. In fact, even with treatment, blindness occurs in 1 out of 20 cases.

What are the serious complications of giant cell arteritis?

As with other vascular diseases, giant cell arteritis does produce a myriad of serious complications. Just like the symptoms, these complications depend on the arteries being affected. The most common, and perhaps the most severe, complications of the disease include nerve damage, aortic aneurysm (ballooning and weakening of the aortic artery), heart attack, and stroke. These complications are very likely to be prevented if treatment began soon after the symptoms become apparent.

How is giant cell arteritis treated?

In giant cell arteritis, treatment is instituted as soon as possible, based on the patients symptoms are detected. This is because complications develop quite rapidly, so risk reduction is necessary. Treatment is also important to relieve symptoms such as headache.

Being an inflammatory disease, giant cell arteritis is treated primarily with steroidal anti-inflammatory drugs such as prednisone and prednisolone, although in some cases, Non-Steroidal Anti-Inflammatory Drugs, or NSAIDs, are also prescribed. The most commonly-prescribed NSAID for this disease is aspirin, which serves not only to relieve inflammation, but to directly prevent stroke and heart attack as well. Proton pump inhibitors (rabeprazole, omeprazole, esomeprazole, etc.) are also given to prevent stomach ulcers that may result from the use of anti-inflammatory drugs.

The “Gold Standard” for diagnosing temporal arteritis is biopsy. Recent studies have shown that 3T MRI using super-high resolution imaging and contrast injection can non-invasively diagnose this disorder with high specificity and sensitivity.

If you suspect that you are suffering from this disease, it is imperative that you seek consultation from a neurological or neurosurgical physician immediately, to avoid the serious complications mentioned above.

If you’re experiencing any type of headache pain, schedule an appointment with one of our headache specialists immediately for proper diagnosis and treatment.