title: Headache and temporal arteritis: when to suspect and how to manage.
abstract: Temporal arteritis, also termed giant cell arteritis, is one of the vasculitides affecting large and medium sized cranial arteries, particularly of the carotid tree. Clinical manifestations may vary from the classic constellation of temporal headache in the elderly accompanied by constitutional signs, jaw claudication, and visual symptoms; therefore, a high index of clinical suspicion may be necessary to identify the disorder. Once suspected, immediate treatment is crucial while exploring any number of diagnostic tools to confirm or refute the diagnosis, since morbidity from untreated temporal arteritis can be devastating. At the same time, achieving a definitive diagnosis is paramount, as treatment can be toxic with significant morbidity of its own. Temporal artery biopsy remains the gold standard, but noninvasive diagnostic approaches are being refined. Corticosteroids remain the cornerstone of treatment, but are ineffective for, not tolerated by, or contraindicated in some individuals, necessitating the exploration of alternatives.
authors.affiliation: Department of Neurology, Thomas Jefferson University Hospital, Jefferson Headache Center, Philadelphia, PA 19107-5092, USA. stephanie.nahas@jefferson.edu
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Nahas
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006261:Headache / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D009460:Neurologic Examination; D018570:Risk Assessment; D012307:Risk Factors; D013699:Temporal Arteries / Q000473:pathology*
chemical_list: D000305:Adrenal Cortex Hormones; D018836:Inflammation Mediators