Giant (temporal) cell arteritis (GCA)
GCA is a form of vasculitis
involving cell-mediated immune damage
to blood vessel walls and mainly affects
blood vessels in the head and neck
region. It is rare under the age of 50
years and females are about 3 times
more likely than men to develop this
disease. The temporal artery is commonly
affected giving rise to temporal arteritis.
Symptoms include unilateral or bilateral
headache of aching or throbbing quality,
often intense and continuous. Patients
may have features of scalp tenderness,
visual changes and/or neurological
changes.
Criteria stipulated by the
International Headache Society (IHS) for
a diagnosis of temporal arteritis is any
new persistent headache in the temporal
region, with either swollen tender scalp
artery (Figure 3) and raised ESR or CRP,
or temporal artery biopsy demonstrating
giant cell arteritis.19 Major improvement
or resolution of headache within 3 days
of high dose steroid treatment also helps
confirm the diagnosis.
GCA may be associated with
polymyalgia rheumatica, jaw claudication,
weight loss, altered sensation or loss of
vision. Owing to the high risk of early
visual loss as a result of anterior ischaemic
optic neuropathy, prompt diagnosis and
management is essential.
Giant (temporal) cell arteritis (GCA)GCA is a form of vasculitisinvolving cell-mediated immune damageto blood vessel walls and mainly affectsblood vessels in the head and neckregion. It is rare under the age of 50years and females are about 3 timesmore likely than men to develop thisdisease. The temporal artery is commonlyaffected giving rise to temporal arteritis.Symptoms include unilateral or bilateralheadache of aching or throbbing quality,often intense and continuous. Patientsmay have features of scalp tenderness,visual changes and/or neurologicalchanges.Criteria stipulated by theInternational Headache Society (IHS) fora diagnosis of temporal arteritis is anynew persistent headache in the temporalregion, with either swollen tender scalpartery (Figure 3) and raised ESR or CRP,or temporal artery biopsy demonstratinggiant cell arteritis.19 Major improvementor resolution of headache within 3 daysof high dose steroid treatment also helpsconfirm the diagnosis.GCA may be associated withpolymyalgia rheumatica, jaw claudication,weight loss, altered sensation or loss ofvision. Owing to the high risk of earlyvisual loss as a result of anterior ischaemicoptic neuropathy, prompt diagnosis andmanagement is essential.
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