Definition & Overview

Giant cell arteritis is a medical condition that is characterized by inflamed blood vessels that lead to the narrowing of the blood’s passageway thus increasing the risk of obstructed blood flow. It is a part of a group of diseases known as vasculitis or arteritis, with the main distinction being the type of blood vessels that are affected. With giant cell arteritis, the affected blood vessels are the ones located in the area surrounding the scalp, head, and temples, particularly the lining of the arteries. Because of its location, giant cell arteritis is also called temporal or cranial arteritis.

Giant cell arteritis can cause jaw pain, headache, and blurred vision. If left untreated, the condition can lead to loss of vision and stroke. However, if immediate medical attention is obtained and if the condition is treated properly, the risk of it recurring is very slim.

Cause of Condition

The main cause of giant cell arteritis is yet to be established. The condition occurs when the lining of some parts of the arteries become inflamed, which can lead to the obstruction of blood flow. However, although what occurs within the arteries when the condition occurs is known, there is no conclusion as to what triggers the inflammation in the first place.

The symptoms of the condition, however, are all linked to the inflammation of the arteries. The swelling most typically occurs in the temporal arteries of the head, which are located near the ears and continue all the way up to the scalp. There are cases where only a part of the artery becomes swollen, leaving sections in between the affected parts in normal size.

Despite the lack of information about its cause, giant cell arteritis is often associated with polymyalgia rheumatica (PMR). In fact, in many cases, the occurrence of giant cell arteritis overlaps with the occurrence of PMR. About 5% to 15% of patients with PMR are also likely to experience giant cell arteritis, and about 50% of patients who originally had giant cell arteritis also experience the symptoms of PMR. People with polymyalgia rheumatica experience stiffness and aching in the neck, hips, and shoulders.

Some people have also been observed to have a higher risk of developing the disease and these include those who are aged over 50. Also, it is more prevalent in women and people of Northern European decent, particularly the Scandinavians.

Key Symptoms

To understand the origin of the symptoms manifested by giant cell arteritis sufferers, it is important to understand the role that the blood vessels play in the body. The major function of the body’s main artery (called the aorta) is to allow oxygenated blood to flow from the heart. The aorta is subdivided into smaller arteries which main task is to deliver blood to all the other parts of the body, which include the brain and internal organs. These are the arteries that become inflamed when giant cell arteritis occurs. Because of the function of the arteries, the blood flow becomes affected, which then leads to complications and symptoms, such as:

  • Localized headache around the temple area or at the front of the head
  • Jaw pain or jaw claudication
  • Loss of vision
  • Double vision
  • Fever
  • Muscle stiffness
  • Tenderness on the scalp
  • Unexplained weight loss

The symptoms of giant cell arteritis tend to vary in every case. In some cases, the symptoms can manifest as a bout of flu with all its usual symptoms, whereas in some cases, the symptoms can also cause a general feeling of being unwell. The headaches caused by giant cell arteritis are characterized by a feeling of pain and tenderness on the head. The pain usually occurs on one or both the temples. When one is experiencing tenderness, he or she may feel uncomfortable even when combing the hair or laying the head on a pillow because the scalp feels inflamed.

Who to See and Types of Treatments Available

Obtaining prompt medical attention to treat giant cell arteritis prevents complications such as stroke and blindness. However, the condition is particularly difficult to diagnose because most of its symptoms are similar to those caused by a lot of other diseases. To determine if a patient has giant cell arteritis, doctors typically perform a wide variety of test including the following:

  • Physical exam
  • Blood tests
  • Biopsy
  • Magnetic resonance angiography
  • Doppler ultrasound
  • Positron emission tomography

The treatment of giant cell arteritis involves corticosteroid drugs such as prednisone. High doses of this medication are necessary. Most doctors are likely to prescribe certain types of drugs even before making an official diagnosis to relieve the symptoms and prevent other more serious symptoms, such as vision loss, from developing. Doctors often prescribe corticosteroids, which are known as powerful anti-inflammatory drugs with effects similar to the hormones produced by adrenal glands. These drugs are known for their effectiveness in relieving pain. However, if used for a prolonged period, corticosteroids can cause several serious side effects, especially if taken at high dosages.

After taking the prescribed medication, the patient may start to feel better within a few days. However, the medication must still be taken continuously for at least a year, depending on the patient’s situation. The doctor may start to lower the prescribed dosage after the first month, and continuously to do so gradually until the lowest possible dosage allowed is reached. Corticosteroids can control the inflammation within the arteries and relieve the symptoms it causes. To determine whether the medications are beneficial, the attending physician will regularly measure the inflammation in the arteries through several tests including a CPR test.

References:

  • Hellmann DB. Giant cell arteritis, polymyalgia rheumatica, and Takayasu's arteritis. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Welley's Textbook of Rheumatology. 9th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 88
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