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Query: UMLS:C0039483 (giant cell arteritis)
 3,204 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It is important to establish the diagnosis of temporal arteritis because the disease is treatable; treatment may prevent blindness and even death. Temporal arteritis usually occurs in people older than 51 years of age, although very rarely, histologically documented disease occurs in younger people. The onset may be occult, so that there are few findings. A multitude of signs and symptoms may occur such as fever, headaches, malaise, weight loss, anemia, stroke, cranial nerve palsies, polymyalgia rheumatica, aortitis and other large vessel involvement. The eye may suffer from ischemic optic neuropathy (anterior or posterior), central or cilio-retinal arterial occlusion, ophthalmic artery ischemia, or extraocular muscle palsies. An arterial biopsy showing giant cell arteritis establishes the diagnosis. However, a negative biopsy does not rule out the disease because of the occasional presence of skip areas. Arteriography has only rarely yielded a positive temporal artery biopsy when the initial biopsy done elsewhere was negative. As a diagnostic parameter, the erythrocyte sedimentation rate is nonspecific, being elevated in diseases other than temporal arteritis and sometimes being falsely lowered by technical factors. Furthermore, the temporal artery biopsy is occasionally positive despite a normal erythrocyte sedimentation rate. Treatment is aimed at relieving the patient's symptoms and normalizing the erythrocyte sedimentation rate. Because of the wide spectrum of clinical and laboratory finding in temporal arteritis, no one specific treatment regimen with systemic corticosteroids works for all patients. Temporal arteritis is a well known disease of the elderly which ir rarely fatal but results in significant visual morbidity (Hinzpeter & Naumann, 1976; Spencer & Hoyt, 1960). Since Hutchinson's (1890) description, more than a thousand articles have been written on the subject (Cohen & Smith, 1974). Despite this, many unanswered questions and controversies remain concerning the diagnosis, prognosis and treatment of temporal arteritis. My goal is to review these questions and areas of controversy.
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PMID:Controversies regarding giant cell (temporal, cranial) arteritis. 39 20

Headache may be the presenting symptom of many diseases in the elderly. Some headaches are caused by significant intracranial disease, and the patient's age and general cardiologic and respiratory status may not allow investigation or neurosurgical management. Conditions that demand urgent neurosurgical attention are subarachnoid hemorrhage, pituitary apoplexy, subdural hematoma, and meningioma. Cranial arteritis, too, should be remembered as a possible medical cause of headache in the elderly.
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PMID:Differentiating causes of headache. 88 44

Symptomatic or secondary headache occurs when pain itself is a symptom of disease. It is well known that within the general population the percent frequency of secondary headache is lower than that of primary headache. Moreover, some forms do not seem to evidence particular clinical, diagnostic or physiopathological importance. The Authors investigate here a number of clinical aspects of secondary headache, in particular headache in vascular disease (stroke, hypertension, Horton's arteritis). Particular attention is paid to headache in brain neoplasia due to the interest brought about by the diagnostic problems of this disease. Lastly postural headache and its prevalence in the general population is examined. Various physiopathological aspects of this form (stress, psychosocial events) are evaluated.
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PMID:[Symptomatic headaches in internal medicine: the classification, physiopathological and diagnostic aspects]. 129 96

Infarcts in the territory of cerebellar arteries, often involving both brainstem and cerebellum, have been well recognized in recent pathological and clinicoradiological studies. To evaluate the situation of pure cerebellar infarcts (PCI) we studied 30 consecutive cases of symptomatic PCI (22 men and 8 women, mean age 58 +/- 17 years) admitted over a 5-year period and selected on the basis of brain computed tomography completed by magnetic resonance in 20 cases and angiography in 15 cases. PCIs accounted for 53 percent of cerebellar infarcts, 10 percent of vertebrobasilar infarcts and 3.2 percent of all cerebral infarcts. The arterial territories involved were the superior cerebellar artery (SCA) in 13 cases (alone in 8 cases), the anterior inferior cerebellar artery in 2 cases, the posterior inferior cerebellar artery (PICA) in 17 cases (alone in 13 cases) and border areas in 5 cases (associated with SCA or PICA). The symptoms were the same in the arterial territories involved (SCA versus PICA), except for dysmetria and vestibular syndrome which were more frequent respectively in SCA territory infarction (P < 0.001) and in PICA territory infarction (P < 0.01). Certain or presumed causes were cardiogenic embolism (23 percent), atherosclerosis (43 percent) and other identified causes, such as oral contraceptives or temporal arteritis (10 percent). They remained undetermined in 24 percent of the cases. Although most patients were severely disabled in the acute stage (Barthel index < 60 in 21 cases), 90 percent recovered subsequently (Barthel index about 100 and 0-2 score on modified Rankin scale). Our findings indicate that symptomatic PCIs are rare; their main causes (cardioembolism and atherosclerosis) do not differ in frequency from those of all cerebral infarcts collected in stroke registries and their functional prognosis is good in almost all cases.
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PMID:[Pure cerebellar infarction. Thirty cases]. 147 Jun 12

Arteritis is a complex and totally underestimated clinical entity that may present in several ways. Due to the diversity of clinical features and the frequent overlapping of clinical syndromes, many different classifications are available for arteritides, but the simplest classification for the practicing physician is the broad division of arteritis into giant cell arteritis and non-giant cell arteritis. Giant cell arteritis encompasses two distinct clinical entities that are pathologically indistinguishable from each other; but both involve arteritis of median and large-sized arteries characterized by an infiltration of giant cells. These include temporal arteritis and Takayasu's arteritis. The non-giant cell arteritis encompasses a greater variety of uncommon diseases that are often associated with other systemic processes such as systemic lupus erythematosus or periarteritis nodosa, and it generally results in ischemic organ dysfunction that is amenable only to medical treatment. Less commonly, however, non-giant cell arteritis may become manifested as acute arterial occlusion caused by circulating anticoagulants, abdominal apoplexy as intra-abdominal bleeding from rupture of micro aneurysms of artery branches, gastrointestinal bleeding from local necrosis of the gastrointestinal tract, or deep-vein thrombosis secondary to hypercoagulable states. Although temporal arteritis has generated a voluminous body of literature, its precise etiology remains elusive. This study summarizes our experience in 15 cases of temporal arteritis and one case is presented to increase knowledge about this disease entity.
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PMID:Diagnosing giant cell temporal arteritis. 160 68

Giant cell (temporal) arteritis is a serious inflammatory condition that can lead to blindness, stroke, or other adverse sequelae if not properly treated. An elevated erythrocyte sedimentation rate has traditionally been emphasized as a criterion for making this diagnosis. Delays in diagnosis and unnecessary testing may occur when a patient presents with a normal erythrocyte sedimentation rate and a clinical history consistent with this condition. We describe a patient with giant cell arteritis who presented with a normal erythrocyte sedimentation rate and who subsequently developed devastating central nervous system complications.
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PMID:Giant cell arteritis. A case with unusual neurologic manifestations and a normal sedimentation rate. 172 19

Giant cell arteritis (GCA) is a common vasculitic disease in the elderly, with a multitude of neurologic manifestations including, but not limited to, stroke and blindness. Many uncommon manifestations are often unrecognized and proper diagnosis and treatment delayed. This review focuses on the pathophysiology and neurologic symptoms of GCA, with special emphasis on the diversity of ocular involvement.
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PMID:Neurologic manifestations of giant cell arteritis. 201

Giant cell arteritis (GCA) is a vasculitis which involves in a systemic fashion the mean and medium sized arteries. Intracranial vessels are exceptionally involved. Thus, stroke is an uncommon complication. We report a patient with typical GCA with blindness due to occlusion of the central artery of the retina, who developed an imitation and utilization behavior attributable to bilateral frontal infarction without accompanying neurological symptoms. Although histological study was not available, this case fulfilled all of Russi's criteria for GCA localized in the CNS. This lends support to the suspicion that the bilateral frontal infarction might be due to it.
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PMID:[Bilateral frontal infarct with imitation and utilization syndrome in a case of giant cell arteritis]. 236 Oct 38

The first population-based incident case-control study of temporal arteritis (TA) in the US was conducted using the unique data resources of the Rochester Epidemiology Project. During the period 1950-1985, 88 newly diagnosed cases of biopsy-proven TA were identified among residents of Olmsted County, Minnesota. Cases were each matched to four Olmsted County community controls on age, sex and duration of community medical record. Odds ratios (OR) were calculated for marital status, education, Quetelet index, pregnancy, age at menopause, thyroid disease, diabetes, smoking, hypertension, angina, myocardial infarction, peripheral vascular disease, and stroke. Multivariable conditional logistic regression analysis identified statistically significant adjusted OR for smoking (2.3, 95% CI = 1.3-4.1). Elevated ORs which were not statistically significant were noted for angina, myocardial infarction, and peripheral vascular disease. These data suggest that TA and arteriosclerosis may share a common causal pathway. Alternatively, histopathological misclassification of temporal artery biopsies may have resulted in the observed association. Due to the limited power of this population-based study, multicentre collaboration should be encouraged to more precisely define the epidemiology of TA.
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PMID:A population-based case-control study of temporal arteritis: evidence for an association between temporal arteritis and degenerative vascular disease? 262 Oct 19

Circulatory disturbances of the tongue are extremely rare because of its rich blood supply. Based on five case reports and a review of the literature we show that lingual circulatory disturbances may be due to impairment of venous drainage resulting in a large acute swelling of the tongue, or to ischemia carrying a painful tongue swelling, and possibly ulceration or partial tongue necrosis. The impairment of venous drainage appears to develop only as a consequence of an extensive posttraumatic or inflammatory edema of the floor of the mouth and tongue base. Ischemic lingual necrosis is most often due to giant cell arteritis and mostly occurs in elderly women. The correct diagnosis should be established as soon as possible because high-dose cortisone therapy both relieves the patient's complaints and prevents life-threatening complications such as myocardial infarction and apoplexy.
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PMID:[Acute circulatory disorders of the tongue]. 336 Jun 28


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