Temporal ArteritisTemporal arteritis or giant cell arteritis is a rare type of headache, usually seen in people over the age of 50. Why is that? Because this is an inflammatory reaction in the arteries which is usually accompanied by blurry vision in one or both eyes, if left untreated, a person may lose their eyesight. They also run the risk of a stroke.
This type of headache usually starts as a dull throbbing headache at one temple. Rarely is it on both sides. Blurry vision that comes and goes may also be present as is tenderness in the jaw. This causes pain when chewing food.The pain in the jaw may radiate down the neck.
Some people complain of tenderness to the scalp and have difficulty combing their hair.
The symptoms may occur any time of the day, and most patients are found to be treating this "new" headache with Tylenol or Excedrin or aspirin.This is one of those
emergency headachesthat I have referred to on other pages.
Testing For Temporal ArteritisThe first tests to be ordered to confirm this type of headache are bloodwork items. A CBC to rule out anemia should be done as anemia can present with this condition but just because you are anemic doesn't mean you will get this headache.
The most important blood test is an ESR which is a sensitive test for inflammation. The majority of patients will have a high level when tested in the presence of symptoms, but I have seen boarderline results on the blood test be confirmed as positive when a biopsy is then done. We also order another test, CRP, which is also a marker for inflammation.
BIOPSY??? What did she say? Well this is the gold standard test to confirm temporal arteritis.
A small amount of tissue is taken from the temporal artery after the area is numbed up. A pathologist will then confirm that the artery is inflammed.
BUT REMEMBER...we treat patients not lab results! A patient with symptoms should be treated before reaching for any tests, just because of the risk of blindness and stroke.
MRI: MRI's of the brain may be performed if a small stroke is suspected or if this is a new atypical headache.
Treatment of Temporal ArteritisTreatment for this type of headache is straight forward. Steroids are given for 1-2 months usually with great results. The headache goes away and vision clears within a day or so.
After a few months a slow taper of the steriods can begin to avoid any rebound effects from stopping steroids too suddenly..so if you are on steroids, don't do this!!
Steroids include dexamethasone, prednisone and methylprednolisone.
Side effects of steriods range from upset stomach, aching joints and muscle pains to night sweats and irritability.
Diabetics must monitor sugars more closely as steroids raise glucose levels, but usually a short term increase in diabetic medications solves the problem.
Not sure this is you? Then read more about different types of headaches.