Giant cell (temporal, cranial) arteritis

Alternative names:

cerebral vasculitis

Symptoms:

• fever
• a headache
  • on one side of the head or the back of the head
  • throbbing

• scalp sensitivity, tenderness when touching the scalp
• jaw pain, intermittent or when chewing
• vision difficulties
  • blurred vision, double vision
  • reduced vision, blindness in one or both eyes

• weakness, excessive tiredness
• a general ill feeling
• a loss of appetite
• weight loss (more than 5% of total body weight)
• muscle aches
• excessive sweating

Additional symptoms that may be associated with this disease:

• mouth sores
• joint stiffness
• joint pain
• hearing loss
• gums, bleeding
• face pain

Signs and tests:

Palpation of the head shows scalp sensitivity and often shows a tender, thick, palpable artery on one side of the head. The affected artery may have a weakened pulse or no pulse. About 40% of people will have other nonspecific symptoms such as respiratory complaints (most frequently dry cough) or mononeuritis multiplex (weakness and/or pain of multiple individual nerve groups). Rarely, ocular palsies (paralysis of eye muscles) may occur. Fever may be the only symptom (the person presents with a persistent fever of unknown origin).

Blood tests are nonspecific.

• A sedimentation rate (ESR) is almost always very high.
• A hemoglobin or hematocrit may be normal or low.
• Liver function tests may be abnormal if the disorder is systemic.
• Alkaline phosphatase may be elevated.

A biopsy and analysis of tissue from the affected artery show changes that confirm the diagnosis of cerebral vasculitis in most cases.