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The temporal area may be tender. [21] Decreased pulses may be found throughout the body [21] Evidence of ischemia may be noted on fundal exam. [21] Bruits may be heard over the subclavian and axillary arteries [21] Intermediate magnification micrograph showing giant cell arteritis in a temporal artery biopsy. The arterial lumen is seen on the left.
A sample (biopsy) of the temporal artery should be obtained to confirm the diagnosis and guide future management, but should not delay initiation of treatment. Treatment does not recover lost vision, but prevents further progression and second eye involvement. High dose corticosteroids may be tapered down to low doses over approximately one year.
The current highest standard for diagnosis is a temporal artery biopsy. [12] The skin on the patient's face is anesthetized, and an incision is made in the face around the area of the temples to obtain a sample of the temporal artery. The incision is then sutured.
Temporal arteritis is an inflammatory disease of medium-sized blood vessels that happens especially with advancing age. AAION occurs in about 15-20 percent of patients with temporal arteritis. Damage to the blood vessels supplying the optic nerves leads to insufficient blood supply ( ischemia ) to the nerve and subsequent optic nerve fiber death.
Polymyalgia rheumatica is sometimes associated with temporal arteritis, a condition requiring more aggressive therapy. To test for this additional disorder, a biopsy sample may be taken from the temporal artery. [17]
The parietal branch of the superficial temporal artery (posterior temporal) is a small artery in the head.It is larger than the frontal branch and curves upward and backward on the side of the head, lying superficial to the temporal fascia; it joins with its fellow of the opposite side, and with the posterior auricular and occipital arteries.
In cases where symptoms suspicious of giant cell arteritis (GCA) are present, but a temporal artery biopsy reveals fibrinoid necrosis in small vessels branching from the temporal artery, and the absence of the typical GCA histological features, this discrepancy may suggest an alternative diagnosis, as the occurrence of fibrinoid necrosis in GCA ...
The most definitive diagnostic modality is a biopsy of the affected blood vessel however brain biopsy has a low yield, with up to 30-50% of biopsies being normal in suspected cases. [5] This is due to some cases having an irregular distribution of vessel involvement (making biopsy technically difficult) or larger vessels being unable to be ...