Temporal Arteritis

WHAT YOU SHOULD KNOW:

Temporal Arteritis (Inpatient Care) Care Guide

  • Temporal (TEM-po-ral) arteritis (ahr-ter-I-tis) is also called giant cell arteritis or cranial arteritis. This is a condition where one or both of the temporal arteries are inflamed (swollen). Temporal arteries are blood vessels that carry oxygen and are located above and in front of the ears. With temporal arteritis, the arteries are damaged and scars may form in them. This makes the temporal arteries swollen, narrow, and tender. Over time, the swollen and narrowed temporal arteries cause decreased blood flow to the eyes, face, and brain. People who have temporal arteritis often also have polymyalgia rheumatica. Polymyalgia rheumatica is a disease which causes pain and stiffness of the muscles and joints of the body. Both diseases may occur at the same time or one after the other.

  • Severe and throbbing headache is the most common symptom of temporal arteritis. Your temporal arteries may also be enlarged or bulging. Other symptoms may include fever; jaw, tongue, muscle and joint pains; loss of appetite; or weight loss. Temporal arteritis is diagnosed by blood tests, biopsy, angiography, arterial doppler, or magnetic resonance imaging (MRI) scan. Treatment includes medicines, such as steroids, immunoglobulins, immunosuppressants, and aspirin. With proper treatment, you have a greater chance of having a full recovery and preventing further problems. Ask your caregiver for more information about these tests and treatments.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Temporal arteritis is a serious, life-threatening condition, and treatment should begin as soon as possible. Your health, quality of life and ability to function may change. Treatment for temporal arteritis may cause unwanted side effects. Medicines may cause you to have rashes, nausea (upset stomach) or vomiting (throwing up). Steroids may cause bone problems, muscle weakness, high blood pressure and sugar levels, or weight gain. Other medicines may lower the body's immune system and increase your chance of getting infections.

  • If not treated early, your temporal artery may continue to swell and narrow. When this happens, you may have problems seeing or go totally blind. Aneurysm (bulge in the blood vessel) may form and rupture, leading to a stroke. Sometimes, those who have temporal arteritis may suddenly have chest pains or a heart attack and die. Ask your caregiver if you have questions or concerns about your condition, medicines, or care.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV

is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

You may need any of the following:

  • Antibiotics or antivirals: Antibiotics or antiviral medicines may be given to help you treat or prevent an infection caused by bacteria or viruses (germs).

  • Clot busters: This medicine helps break apart clots. It is given IV and may be given at the same time as other blood thinners. This medicine could save your life because blood clots in the heart, lungs or brain can kill you. Be careful because you may bleed or bruise easily.

  • Steroids: This medicine may be given to decrease inflammation.

  • Vitamin D and calcium supplements: Vitamin D and calcium may be given when you are using steroid medicines. These supplements make sure your bones are getting enough nutrition and help prevent bone loss.

  • Others: In some cases, an immune globulin or immunosuppressant may be offered to help treat temporal arteritis. Ask your caregiver for more information about how these medicines may help you.

    • Antiplatelets help prevent blood clots. This medicine makes it more likely for you to bleed or bruise.

    • Immune globulins: This medicine is given as a shot or an IV infusion to make your immune system stronger. You may need immune globulins to treat or prevent an infection. It is also used when you have a chronic condition, such as lupus or arthritis. You may need many weeks of treatment. Each infusion can take from 2 to 5 hours.

    • Immunosuppressant: This medicine prevents the immune system from attacking your body. This may be offered if you have certain immune diseases such as rheumatoid arthritis.

Tests:

You may have any of the following:

  • Biopsy: Caregivers may need to remove a small part of your temporal artery. The tissue will then be sent to the lab for tests.

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • Imaging tests:

    • Angiography: This test looks for problems with your temporal arteries. Before the x-ray, a dye is put into a thin tube through a small cut in your groin. The groin is the area where your abdomen (stomach) meets your upper leg. The dye helps the arteries show up better on these x-ray pictures. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to shellfish, dyes, or any medicines.

    • Arterial doppler: An arterial doppler test is done to check blood flow through an artery. A small metal disc with gel on it is placed on your skin over the artery. You can hear a "whooshing" sound when the blood is flowing through the artery. An "X" may be marked on your skin where caregivers feel or hear the blood flowing best. Caregivers may need to check blood flow more than once.

    • Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.

    • Computerized tomography scan: This is also called a CT scan. A special x-ray machine uses a computer to take pictures of your head, including your temporal arteries. You may be given dye through an IV before the pictures are taken so that your organs show clearly. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish or have other allergies or health problems.

    • Magnetic resonance imaging scan: This test is called an MRI scan. During the MRI, pictures are taken of your head. An MRI may be used to look at the brain, muscles, joints, bones, or blood vessels. You will need to lie still during a MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury.

    • Positron emission tomography scan: This test is also called a PET scan. A PET scan shows the areas of the head where there are problems in the blood vessels. It also shows how much blood and oxygen is flowing to an area of the brain and other parts of the head.

Vital signs:

Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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