Giant Cell Arteritis: Headache and Vision Warning Signs to Know

What it involves

MedlinePlus explains that giant cell arteritis is a disorder that causes inflammation of the arteries, usually in the scalp, neck and arms. It narrows the arteries and keeps blood from flowing well. It often occurs with polymyalgia rheumatica, both are more common in women than men, and they almost always affect people over 50.

Who this is for

• Adults over 50 with a new headache, scalp or temple tenderness or jaw pain.
• Patients with polymyalgia rheumatica who develop headaches or vision changes.
• People with fever, tiredness and loss of appetite that seem like the flu but do not clear.
• Anyone who has had a vision change and wants a full evaluation after emergency care.

What to expect

• Questions about the headache, scalp tenderness, jaw pain, vision, fever and muscle stiffness
• An exam that includes the temples, pulses, vision complaints and neurological signs
• Blood work, which the practice offers, to look for inflammation
• A same-day referral to a specialist or hospital when giant cell arteritis is suspected

Go to the ER for vision loss

MedlinePlus says early treatment is important because otherwise there is a risk of permanent vision loss or stroke. Sudden loss of vision in one eye, double vision, or stroke signs such as a drooping face, weak arm or trouble speaking are emergencies. Call 911 or go to the ER rather than waiting for an appointment. The stroke warning signs guide lists what to watch for, and the blurry vision guide covers less sudden changes.

What it can feel like

The summary describes early symptoms that resemble the flu: fatigue, loss of appetite and fever. Other symptoms include headaches, pain and tenderness over the temples, double vision or visual loss, dizziness, problems with coordination and balance, and pain in the jaw and tongue. A new headache in an older adult is different from an old migraine pattern, which is covered in the headache and migraine guide. A provider will ask how this one differs.

The connection to polymyalgia rheumatica

MedlinePlus says giant cell arteritis often occurs with polymyalgia rheumatica, and that polymyalgia rheumatica sometimes occurs along with it. If you have stiff, aching shoulders and hips, the polymyalgia rheumatica guide explains that condition. Tell your provider about both sets of symptoms, because treatment decisions depend on the full picture. Fever and tiredness that linger are discussed in the fever in adults guide.

How it is evaluated

Your doctor will make the diagnosis based on your medical history, symptoms and physical exam, according to MedlinePlus. There is no specific test, but tests that measure inflammation may be done, and MedlinePlus lists the erythrocyte sedimentation rate and C-reactive protein blood tests. The practice offers blood work. Because this is time-sensitive, a provider may send you directly to a hospital or a specialist who can arrange further testing, which is outside what the practice does in the office.

Treatment

MedlinePlus says treatment is usually with corticosteroids, and that when properly treated giant cell arteritis rarely comes back. Steroids are powerful medicines with side effects, so they are started and adjusted under medical supervision, and you should never stop one suddenly. A primary care provider can help coordinate your care with a rheumatologist or eye specialist, and follow blood pressure, blood sugar and bone health while you are on treatment, as the bone density screening guide describes.

When to be seen the same day

Call the office the same day for a new headache with tender temples or scalp, jaw pain that comes on with chewing, or an unexplained fever with stiffness after 50. If you cannot be seen that day, go to an urgent care or ER instead of waiting, and use the sick visit versus urgent care or ER guide to help you decide. Call 911 for any sudden vision change. Walk-ins and same-day visits are welcome at the offices.

Sources

• MedlinePlus: Giant Cell Arteritis (Temporal Arteritis)
• MedlinePlus: Polymyalgia Rheumatica