Temporal arteritis, also known as giant cell arteritis (GCA), is a medical condition characterized by inflammation of blood vessels, primarily those located in the head. This inflammation can affect various arteries, including those supplying the scalp, jaw muscles, and the optic nerve. It demands prompt medical attention due to its potential for severe complications if left unaddressed.
Understanding Temporal Arteritis
Temporal arteritis is an autoimmune condition where the body’s immune system mistakenly attacks healthy arteries, causing them to become swollen and narrowed. This inflammation most commonly affects the temporal arteries, which run along the temples, but it can also impact other medium and large blood vessels throughout the body, including the aorta and its branches.
Individuals with temporal arteritis experience symptoms such as a persistent, throbbing headache, typically on one side or at the front of the head. Other signs include tenderness or pain in the scalp or temples, jaw pain that worsens with chewing or talking, and visual disturbances like double vision, blurry vision, or temporary vision loss. Fatigue, fever, and unexplained weight loss can also occur. It predominantly affects older adults (usually over 50) and is more common in females and those of Northern European ancestry.
Why Self-Healing is Not Expected
Temporal arteritis is a progressive inflammatory condition that does not resolve spontaneously. Without medical intervention, the ongoing inflammation can lead to permanent damage to the affected blood vessels, significantly reducing blood flow to vital organs and tissues. This lack of self-resolution underscores the urgency for treatment.
Untreated temporal arteritis’s most severe complication is permanent vision loss, which can occur suddenly in one or both eyes. This occurs if inflammation affects an artery supplying the optic nerve, damaging it. Other serious complications include stroke or, less commonly, aneurysms—weakened, ballooned areas in artery walls that risk bursting. The risk of these severe outcomes increases significantly with any delay in treatment.
Treatment Approaches
Since temporal arteritis does not self-resolve, medical treatment begins immediately to manage the condition and prevent complications. The primary treatment involves high-dose corticosteroids, such as prednisone, which suppress the immune system and reduce inflammation. Treatment typically begins with a high oral dose (40-60 mg/day), or higher (80-100 mg/day) if visual symptoms are present. Severe cases may start with intravenous corticosteroids.
The initial high-dose treatment is usually maintained for a few weeks until symptoms improve and inflammatory markers in the blood normalize. The dose is then gradually tapered over 12-24 months or several years to minimize side effects and prevent relapses. Some individuals may require treatment for as long as 5 years, or even for the rest of their lives in a small number of cases. The main goals of this long-term treatment are to prevent irreversible complications, especially vision loss, and to alleviate the symptoms of the disease.
Importance of Early Diagnosis and Treatment
Prompt medical attention is important if temporal arteritis symptoms are suspected, given its progressive nature and potential for severe, irreversible damage. Immediate diagnosis and swift treatment are the most effective strategies to prevent permanent complications, especially vision loss, which can develop rapidly. Studies have shown that early recognition and treatment can significantly improve the visual prognosis for patients.
Any delay in starting treatment significantly increases the risk of severe outcomes, including blindness. Individuals experiencing symptoms like a new, persistent headache, scalp tenderness, jaw pain with chewing, or sudden visual disturbances should seek emergency medical care without delay. Early intervention is the most effective way to protect against the severe effects of this condition.