Temporal arteritis occurs mainly in white women in their late life.
Autoimmune processes presumably provide the cause.
New, severe, sustained, steady or throbbing headache most often located
in the temporal region of the scalp and accompanied by a tender, nodular,
or incompressible artery in the area. Head pain also may affect the masseter
or sterno?cleidomastoid muscles, occasionally as the chief symptom.
Associated symptoms may include malaise, fatigue, weight loss, low-grade
fever, and proximal myalgia affecting the pectoral or pelvic girdle areas
(polymyalgia rheumatica). The erythrocyte sedimentation rate (ESR) usually
rises to 60 mm/hr or more.
Firm diagnosis requires a biopsy.
Pathological examination of the offending temporal artery usually shows
an inflammatory response, often with partial or complete occlusion of the
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Temporal arteritis represents a medical emergency, since delaying proper
treatment increases the risk of retinal artery occlusion, thereby producing
partial or com?plete functional loss of vision.
High dose corticosteroids in the presence of a probable clinical diagnosis.
Remarkable resolution within 24hrs is the rule.
Follow up twice monthly for symptoms and ESR to detect relapse.