Temporal (giant cell) arteritis is a common inflammatory disorder that primarily affects the arteries in the extracranial carotid circulation. It is more prevalent among elderly individuals, with an annual incidence of 77 per 100,000 people aged 50 and above. Onset of the condition typically occurs around the age of 70, and women constitute about 65% of the reported cases.

One of the most serious complications of untreated temporal arteritis is blindness, which occurs in approximately half of the patients. This blindness is primarily caused by the involvement of the ophthalmic artery and its branches, leading to ischemic optic neuropathy. Therefore, early recognition and timely treatment of temporal arteritis are crucial in preventing this debilitating outcome.

The hallmark symptom of temporal arteritis is a throbbing headache. It is often the dominant symptom and can be felt unilaterally or bilaterally. The headache is commonly located in the temporal region, but it can also affect other areas of the skull. Patients may find it difficult to brush their hair or rest their head on a pillow due to the pain. The severity of the headache tends to worsen at night and can be exacerbated by exposure to cold temperatures.

Other symptoms that may accompany temporal arteritis include polymyalgia rheumatica (muscle pain and stiffness), jaw claudication (pain while chewing), fever, and weight loss.

While an elevated erythrocyte sedimentation rate (ESR) is often observed in temporal arteritis, it may not always be the case. Therefore, a normal ESR does not definitively rule out the possibility of giant cell arteritis.

To confirm the diagnosis, a temporal artery biopsy is usually recommended. However, in cases where there is a high clinical suspicion of temporal arteritis, immediate treatment with prednisone at a dose of 80 mg daily for 4-6 weeks should not be unreasonably delayed in order to obtain a biopsy.