Temporal Arteritis

WHAT YOU SHOULD KNOW:

• 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. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. 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: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.

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: Steroid medicine may be given to decrease inflammation, which is redness, pain, and swelling.
  
  
• 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.
  
  
  • Aspirin: This is medicine that may be given to help thin the blood to keep blood clots from forming.
    
    
  • Immune globulins: Immune globulins can be used to treat many different problems. It may be given to help your immune system fight infection. It may also help if your body does not produce enough of certain kinds of blood cells. This medicine may help if your system fights something in your blood or body that it should not. Ask your caregiver for more information about how immune globulin medicine may help you.
    
    
  • 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 for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
  
  
• 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: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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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