[Cranial arteritis - An Overview].
BACKGROUND
Cranial arteritis is one of the most important emergency situations in ophthalmology.


METHODS
Recommendations of the literature how to diagnose and how to treat the disease are described.


RESULTS
The basic diagnostic steps such as the "Five Criteria Classification" together with certain exceptions of the classification criteria and the recognition of different facets of the varying clinical picture are emphasised. Special arteritic appearances of the facial artery, the occipital artery and the vertebral artery should be noted and identified. It is pointed out that an arteritis without headache is of great clinical importance, known as occult arteritis, because of the lack of classical symptoms, often leading to a wrong diagnosis. Anterior ischaemic optic neuropathy (AION) is the most frequent cause of blindness. Differential diagnosis between non-arteritic and arteritic AION is emphasised. The different arguments concerning the performance of unilateral or bilateral arterial resection ("biopsy") and the findings of colour duplex ultrasonography in comparison to the histological results are discussed. It is also pointed out that some new diagnostic procedures such as the MRI examination with gadolinium and the PET-Scan examination may be helpful in supporting the diagnosis.


CONCLUSIONS
Cranial arteritis is more often diagnosed in recent years. The diagnosis should be made in cooperation by the ophthalmologist and internists and neurologists. Blindness caused by cranial arteritis is preventable in the majority of patients if diagnosed early and treated properly. For decades of clinical experience it has been well established that early diagnosis and systemic treatment with high doses of systemic corticosteroids are essential in preventing blindness in one or both eyes.
Schmidt
Dieter
D
Universitäts-Augenklinik, Freiburg. schmidt@aug.ukl.uni-freiburg.de
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001706:Biopsy; D001766:Blindness / Q000209:etiology / Q000517:prevention & control; D003952:Diagnostic Imaging; D004630:Emergencies; D005128:Eye Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D011379:Prognosis; D012307:Risk Factors; D013699:Temporal Arteries / Q000473:pathology; D014786:Vision Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents