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Headaches vs. Temporal Arteritis for People Over Fifty
Mrs. Stratton, a 75 year-old woman had experienced mild intermittent headaches for several years until a few weeks ago when she developed a severe throbbing headache at the right temporal area. She explained to her doctor that the pain severity and throbbing was different from her usual headaches. Mrs. Stratton also had jaw pain when she chewed her food and within a few days, she noted double and blurred vision.The diagnosis for her new onset of headache: temporal arteritis.
WHAT IS TEMPORAL ARTERITIS?
When the walls of certain arteries become inflamed, blood vessels can become narrowed and inefficient at supplying adequate oxygen rich blood to the tissue they serve, which is known as vasculitis. Without an adequate blood supply, a tissue will lack nutrients and oxygen and could even die. And when the arteries leading to the temples in the head are involved, the condition is called temporal arteritis (TA). Most commonly, TA affects the temple arteries, but blood vessels supplying the eyes, scalp or even arms and legs may be involved.
Symptoms caused by the lack of blood flow to tissue include headache, scalp, and jaw pain, as well as visual problems, such as blurring, seeing double, intermittent darkening, or loss of vision. Also, since TA is associated with inflammation, it may cause symptoms such as fatigue, anemia, weight loss and general malaise. And last, but definitely not least, the most dreaded and severe complications of TA are blindness and stroke, which result from a blockage of the blood vessels that nourish either the nerve that carries nerve impulses from the eye to the brain, called the optic nerve, or the brain itself.
Despite ample research, the exact cause of TA has not been identified. We do know, however, that TA generally affects people over fifty, especially Caucasians, women more so than men. Furthermore, genetic predisposition and environmental triggers such as a virus seem to play an important role in the development of TA. Typical warning signs for people over the age of fifty are the development of a severe headache, difficulty chewing, visual changes or even unexplained fever.
If your physician suspects TA, a blood test called erythrocyte sedimentation rate (ESR) will be ordered to measure the amount of inflammation present. However, a definite diagnosis is based on a temporal artery biopsy by removal of a sample of tissue from one or both temporal arteries for examination.
Often, TA can be self-limited and may eventually run its course in 2-3 years. And with prompt treatment with high dose corticosteroids, associated inflammation can be effectively reduced and complications such as vision loss and stroke prevented.
By Dr. Yong H. Tsai
Published in The Daytona Beach News-Journal
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