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Giant cell arteritis

Giant cell arteritis is an inflammation of the lining of your arteries — the blood vessels that carry oxygen-rich blood from your heart to the rest of your body. Most often, it affects the arteries in your head, especially those in your temples. For this reason, giant cell arteritis is sometimes called temporal arteritis or cranial arteritis.

Giant cell arteritis frequently causes headaches, jaw pain, and blurred or double vision. Blindness and, less often, stroke are the most serious complications of giant cell arteritis.

Prompt treatment of giant cell arteritis is critical in order to prevent permanent tissue damage and loss of vision. Corticosteroid medications usually relieve symptoms of giant cell arteritis and may prevent loss of vision. You'll likely begin to feel better within days of starting your treatment.

Symptoms Causes Risk factors Complications

The most common symptoms of giant cell arteritis are head pain and tenderness — often severe — that usually occurs in both temples. Some people, however, have pain in only one temple or in the front of the head.

Signs and symptoms of giant cell arteritis can vary. For some people, the onset of the condition feels like the flu — with muscle stiffness and aches (myalgia) around the shoulders and hips, fever and fatigue, as well as headaches.

Generally, signs and symptoms of giant cell arteritis include:

  • Persistent, severe head pain and tenderness, usually in your temple area
  • Vision loss or double vision
  • Scalp tenderness — it may hurt to comb your hair or even to lay your head on a pillow, especially where the arteries are inflamed
  • Jaw pain (jaw claudication) when you chew or open your mouth wide
  • Sudden, permanent loss of vision in one eye
  • Fever
  • Unexplained weight loss

Pain and stiffness in the neck, shoulders or hips are common symptoms of a related disorder, polymyalgia rheumatica. Approximately half the people with giant cell arteritis also have polymyalgia rheumatica.

When to see a doctor

If you develop a new, persistent headache or any of the problems listed above, see your doctor without delay. If you're diagnosed with giant cell arteritis, starting treatment as soon as possible can usually help prevent blindness.

Your arteries are pliable tubes with thick, elastic walls. Oxygenated blood leaves your heart through your body's main artery, the aorta. The aorta then subdivides into smaller arteries that deliver blood to all parts of your body, including your brain and internal organs.

With giant cell arteritis, some of these arteries become inflamed, causing them to swell and sometimes decreasing blood flow. Just what causes these arteries to become inflamed isn't known.

Although almost any large or medium-sized artery can be affected, swelling most often occurs in the temporal arteries in your head, which are located just in front of your ears and continue up into your scalp. In some cases, the swelling affects just part of an artery with sections of normal vessel in between.

Although the exact cause of giant cell arteritis isn't known, several factors can increase your risk, including:

  • Age. Giant cell arteritis affects older adults almost exclusively — the average age at onset of the disease is 70, and it rarely occurs in people younger than 50.
  • Sex. Women are about two times more likely to develop giant cell arteritis.
  • Northern European — especially Scandinavian — descent. Although giant cell arteritis can affect anyone, people born in Northern European countries appear to have higher rates of giant cell arteritis. People of Scandinavian origin are particularly at risk.
  • Polymyalgia rheumatica. People with polymyalgia rheumatica have stiffness and aching in the neck, shoulders and hips. About 15 percent of people with polymyalgia rheumatica also have giant cell arteritis.

Giant cell arteritis can cause the following complications:

  • Blindness. This is the most serious complication of giant cell arteritis. The swelling that occurs with giant cell arteritis narrows your blood vessels, reducing the amount of blood — and, therefore, oxygen and vital nutrients — that reaches your body's tissues. Diminished blood flow to your eyes can cause sudden, painless vision loss in one or, in rare cases, both eyes. Unfortunately, blindness is usually permanent.
  • Aortic aneurysm. Having giant cell arteritis increases your risk of aneurysm. An aneurysm is a bulge that forms in a weakened blood vessel, usually in the aorta, the large artery that runs down the center of your chest and abdomen. An aortic aneurysm is a serious condition because it may burst, causing life-threatening internal bleeding. Because it may occur even years after the initial diagnosis of giant cell arteritis, your doctor may monitor the health of your aorta with annual chest X-rays or other imaging tests, such as ultrasound, CT scan or MRI.
  • Stroke. In some cases, a blood clot may form in an affected artery, obstructing blood flow completely, depriving part of your brain of necessary oxygen and nutrients, and causing stroke. This serious condition is an uncommon complication of giant cell arteritis.
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