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Headache Attributed to Giant Cell (Temporal) Arteritis

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Handbook of Headache

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Abstract

Any new-onset headache in a subject >50 years raises the suspicion of giant cell arteritis (GCA). GCA may cause any type of headache, associated or not with other suggestive clinical features such as fatigue, fever, jaw claudication, temporal arteries abnormalities, shoulder and pelvic girdle pain, or visual alterations. The main risk is visual loss by anterior ischemic optic neuropathy. Diagnosis relies on clinical history (headache in a >50 years old), elevated ESR and CRP, and results of temporal artery biopsy. High-dose glucocorticosteroid therapy should be initiated immediately when clinical suspicion of GCA is raised, before the result of temporal artery biopsy if the clinical suspicion is high, in order to prevent complications. Efficacy of steroids is such dramatic that the persistence of headache after 4 days of treatment should prompt to consider an alternative diagnosis.

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References

  • Achkar AA, Lie JT, Hunder GG, O'Fallon WM, Gabriel SE (1994) How does previous corticosteroid treatment affect the biopsy findings in giant cell (temporal) arteritis? Ann Intern Med 120:987–992

    PubMed  CAS  Google Scholar 

  • Bley TA, Weiben O, Uhl M, Vaith P, Schmidt D, Warnatz K, Langer M (2005) Assessment of the cranial involvement pattern of giant cell arteritis with 3T magnetic resonance imaging. Arthritis Rheum 52:2470–2477

    Article  PubMed  CAS  Google Scholar 

  • Blockmans D, de Ceuninck L, Vanderschueren S, Knockaert D, Mortelmans L, Bobbaers H (2006) Repetitive 18F-fluorodeoxyglucose positron emission tomography in giant cell arteritis: a prospective study of 35 patients. Arthritis Rheum 55:131–137

    Article  PubMed  Google Scholar 

  • Blockmans D, Bley T, Schmidt W (2009) Imaging for large-vessel vasculitis. Curr Opin Rheumatol 21:19–28

    Article  PubMed  Google Scholar 

  • Borg FA, Dasgupta B (2009) Treatment and outcomes of large vessel arteritis. Best Pract Res Clin Rheumatol 23:325–337

    Article  PubMed  Google Scholar 

  • Borg FA, Salter VL, Dasgupta B (2008) Neuro-ophthalmic complications in giant cell arteritis. Curr Allergy Asthma Rep 8:323–330

    Article  PubMed  Google Scholar 

  • Caselli RJ, Daube JR, Hunder GG, Whisnant JP (1988a) Peripheral neuropathic syndromes in giant cell (temporal) arteritis. Neurology 38:685–689

    PubMed  CAS  Google Scholar 

  • Caselli RJ, Hunder GG, Whisnant JP (1988b) Neurologic disease in biopsy-proven giant cell (temporal) arteritis. Neurology 38:352–359

    PubMed  CAS  Google Scholar 

  • Chakrabarty A, Franks AJ (2000) Temporal artery biopsy: is there any value in examining biopsies at multiple levels? J Clin Pathol 53:131–136

    Article  PubMed  CAS  Google Scholar 

  • Chan CC, Paine M, O'Day J (2001) Steroid management in giant cell arteritis. Br J Ophthalmol 85:1061–1064

    Article  PubMed  CAS  Google Scholar 

  • Chevalet P, Barrier JH, Pottier P, Magadur-Joly G, Pottier MA, Hamidou M, Planchon B, El Kouri D, Connan L, Dupond JL, De Wazieres B, Dien G, Duhamel E, Grosbois B, Jego P, Le Strat A, Capdeville J, Letellier P, Agron L (2000) A randomized, multicenter, controlled trial using intravenous pulses of methylprednisolone in the initial treatment of simple forms of giant cell arteritis: a one year followup study of 164 patients. J Rheumatol 27:1484–1491

    PubMed  CAS  Google Scholar 

  • Dasgupta B, Borg FA, Hassan N, Alexander L, Barraclough K, Bourke B, Fulcher J, Hollywood J, Hutchings A, James P, Kyle V, Nott J, Power M, Samanta A (2010) BSR and BHPR guidelines for the management of giant cell arteritis. Rheumatol 49(8):1594–1597

    Article  Google Scholar 

  • Foroozan R, Deramo VA, Buono LM, Jayamanne DG, Sergott RC, Danesh-Meyer H, Savino PJ (2003) Recovery of visual function in patients with biopsy-proven giant cell arteritis. Ophthalmology 110:539–542

    Article  PubMed  Google Scholar 

  • Gonzalez-Gay MA, Garcia-Porrua C, Llorca J, Hajeer AH, Branas F, Dababneh A, Gonzalez-Louzao C, Rodriguez-Gil E, Rodriguez-Ledo P, Ollier WE (2000) Visual manifestations of giant cell arteritis. Trends and clinical spectrum in 161 patients. Medicine (Baltimore) 79:283–292

    Article  CAS  Google Scholar 

  • Gonzalez-Gay MA, Vazquez-Rodriguez TR, Lopez-Diaz MJ, Miranda-Filloy JA, Gonzalez-Juanatey C, Martin J, Llorca J (2009) Epidemiology of giant cell arteritis and polymyalgia rheumatica. Arthritis Rheum 61:1454–1461

    Article  PubMed  Google Scholar 

  • Hall JK, Volpe NJ, Galetta SL, Liu GT, Syed NA, Balcer LJ (2003) The role of unilateral temporal artery biopsy. Ophthalmology 110:543–548, discussion 548

    Article  PubMed  Google Scholar 

  • Hunder GG, Bloch DA, Michel BA, Stevens MB, Arend WP, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY, Lie JT et al (1990) The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum 33:1122–1128

    Article  PubMed  CAS  Google Scholar 

  • Karassa FB, Matsagas MI, Schmidt WA, Ioannidis JP (2005) Meta-analysis: test performance of ultrasonography for giant-cell arteritis. Ann Intern Med 142:359–369

    PubMed  Google Scholar 

  • Kyle V (1991) Treatment of polymyalgia rheumatica/giant cell arteritis. Baillières Clin Rheumatol 5:485–491

    Article  PubMed  CAS  Google Scholar 

  • Loddenkemper T, Sharma P, Katzan I, Plant GT (2007) Risk factors for early visual deterioration in temporal arteritis. J Neurol Neurosurg Psychiatry 78:1255–1259

    Article  PubMed  Google Scholar 

  • Mahr A, Saba M, Kambouchner M, Polivka M, Baudrimont M, Brocheriou I, Coste J, Guillevin L (2006) Temporal artery biopsy for diagnosing giant cell arteritis: the longer, the better? Ann Rheum Dis 65:826–828

    Article  PubMed  CAS  Google Scholar 

  • Mazlumzadeh M, Hunder GG, Easley KA, Calamia KT, Matteson EL, Griffing WL, Younge BR, Weyand CM, Goronzy JJ (2006) Treatment of giant cell arteritis using induction therapy with high-dose glucocorticoids: a double-blind, placebo-controlled, randomized prospective clinical trial. Arthritis Rheum 54: 3310–3318

    Article  PubMed  CAS  Google Scholar 

  • Mukhtyar C, Guillevin L, Cid MC, Dasgupta B, de Groot K, Gross W, Hauser T, Hellmich B, Jayne D, Kallenberg CG, Merkel PA, Raspe H, Salvarani C, Scott DG, Stegeman C, Watts R, Westman K, Witter J, Yazici H, Luqmani R (2009) EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis 68:318–323

    Article  PubMed  CAS  Google Scholar 

  • Nesher G, Berkun Y, Mates M, Baras M, Rubinow A, Sonnenblick M (2004) Low-dose aspirin and prevention of cranial ischemic complications in giant cell arteritis. Arthritis Rheum 50:1332–1337

    Article  PubMed  CAS  Google Scholar 

  • Nuenninghoff DM, Hunder GG, Christianson TJ, McClelland RL, Matteson EL (2003a) Incidence and predictors of large-artery complication (aortic aneurysm, aortic dissection, and/or large-artery stenosis) in patients with giant cell arteritis: a population-based study over 50 years. Arthritis Rheum 48:3522–3531

    Article  PubMed  Google Scholar 

  • Nuenninghoff DM, Hunder GG, Christianson TJ, McClelland RL, Matteson EL (2003b) Mortality of large-artery complication (aortic aneurysm, aortic dissection, and/or large-artery stenosis) in patients with giant cell arteritis: a population-based study over 50 years. Arthritis Rheum 48:3532–3537

    Article  PubMed  Google Scholar 

  • Ray-Chaudhuri N, Kine DA, Tijani SO, Parums DV, Cartlidge N, Strong NP, Dayan MR (2002) Effect of prior steroid treatment on temporal artery biopsy findings in giant cell arteritis. Br J Ophthalmol 86: 530–532

    Article  PubMed  CAS  Google Scholar 

  • Robb-Nicholson C, Chang RW, Anderson S, Roberts WN, Longtine J, Corson J, Larson M, George D, Green J, Bryant G et al (1988) Diagnostic value of the history and examination in giant cell arteritis: a clinical pathological study of 81 temporal artery biopsies. J Rheumatol 15:1793–1796

    PubMed  CAS  Google Scholar 

  • Salvarani C, Cantini F, Hunder GG (2008) Polymyalgia rheumatica and giant-cell arteritis. Lancet 372:234–245

    Article  PubMed  Google Scholar 

  • Salvarani C, Cimino L, Macchioni P, Consonni D, Cantini F, Bajocchi G, Pipitone N, Catanoso MG, Boiardi L (2005) Risk factors for visual loss in an Italian population-based cohort of patients with giant cell arteritis. Arthritis Rheum 53:293–297

    Article  PubMed  Google Scholar 

  • Salvarani C, Macchioni PL, Tartoni PL, Rossi F, Baricchi R, Castri C, Chiaravalloti F, Portioli I (1987) Polymyalgia rheumatica and giant cell arteritis: a 5-year epidemiologic and clinical study in Reggio Emilia, Italy. Clin Exp Rheumatol 5:205–215

    PubMed  CAS  Google Scholar 

  • Schmidt WA (2007) Technology insight: the role of color and power Doppler ultrasonography in rheumatology. Nat Clin Pract Rheumatol 3:35–42, quiz 59

    Article  PubMed  Google Scholar 

  • Smeeth L, Cook C, Hall AJ (2006) Incidence of diagnosed polymyalgia rheumatica and temporal arteritis in the United Kingdom, 1990–2001. Ann Rheum Dis 65:1093–1098

    Article  PubMed  CAS  Google Scholar 

  • Solans-Laque R, Bosch-Gil JA, Molina-Catenario CA, Ortega-Aznar A, Alvarez-Sabin J, Vilardell-Tarres M (2008) Stroke and multi-infarct dementia as presenting symptoms of giant cell arteritis: report of 7 cases and review of the literature. Medicine 87:335–344

    Article  PubMed  Google Scholar 

  • Solomon S, Cappa KG (1987) The headache of temporal arteritis. J Am Geriatr Soc 35:163–165

    PubMed  CAS  Google Scholar 

  • Wong RL, Korn JH (1986) Temporal arteritis without an elevated erythrocyte sedimentation rate. Case report and review of the literature. Am J Med 80:959–964

    Article  PubMed  CAS  Google Scholar 

  • Zenone T (2007) Fever of unknown origin in rheumatic diseases. Infect Dis Clin North Am 21:1115–1135, x–xi

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Headache Emergency Centre, Assistance Publique des Hôpitaux de Paris, Head and Neck Clinic, Lariboisière Hospital, 2 rue Ambroise Paré, 75010, Paris, France

    Dr. Anne Ducros

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  1. Dr. Anne Ducros
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Correspondence to Anne Ducros .

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Editors and Affiliations

  1. Department of Medical and Molecular Sciences, School of Health Sciences, Sapienza University of Rome, Rome, Italy

    Paolo Martelletti

  2. Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway

    Timothy J. Steiner

  3. Department of Neuroscience, Faculty of Medicine, Imperial College London, London, UK

    Timothy J. Steiner

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© 2011 Lifting The Burden

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Ducros, A. (2011). Headache Attributed to Giant Cell (Temporal) Arteritis. In: Martelletti, P., Steiner, T.J. (eds) Handbook of Headache. Springer, Milano. https://doi.org/10.1007/978-88-470-1700-9_38

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  • DOI: https://doi.org/10.1007/978-88-470-1700-9_38

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1699-6

  • Online ISBN: 978-88-470-1700-9

  • eBook Packages: MedicineReference Module Medicine

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