Inflammation of blood vessels in the temple

Causes/Factors

  • Older age
  • Caucasian
  • Smoking
  • Polymyalgia rheumatica

Presentation

  • Severe headache
  • Jaw pain
  • Scalp tenderness
  • Loss of/double vision - can be transient but large risk of permanent loss
  • Prominent temporal vessels but no pulse
  • Pale optic disc

Investigations

  • Painful temporal arteries of palpation/eating
  • CRP, ESR
  • Biopsy for definitive diagnosis
  • USS halo sign

Management

  • High dose corticosteroids - Prednisolone (+ PPI and bisphosphonates for protection of stomach and bones)
  • Rheumatology referral

Complications/red Flags