Published online by Cambridge University Press: 21 November 2024
Also called giant cell arteritis (GCA), temporal arteritis is the most common systemic vasculitis in those greater than 50. It mainly affects large- and medium-sized arteries. Specifically, Caucasian women of northern European descent are the most commonly affected. The histopathology demonstrates granulomatous organization of CD4 cells and macrophages with the formation of giant cells. The carotid arteries are very commonly affected. Patients with GCA also often experience symptoms of headache and jaw claudication. Diplopia can also occur with GCA due to ischemia of the extraocular muscles. But the most significant symptom is transient visual loss, which is caused by the vasculopathy extending into the arteries supplying the retina and the optic nerve. The typical presentation is an acute complete or partial monocular painless visual loss. Although the visual symptoms can be transient, this should prompt an urgent investigation and treatment because of the significant risk of permanent visual loss. Though less common, ischemic strokes can also occur with GCA due to the involvement of the internal carotid arteries and rarely vertebral arteries.
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