Temporal arteritis is a serious condition where the walls of the temporal arteries become inflamed. These arteries run along the sides of your head, near your temples. Without prompt treatment, this condition can lead to permanent vision loss. This article explains what temporal arteritis is, who it affects, how it is diagnosed, and how it is treated in Canada.
What Is Temporal Arteritis?
Temporal arteritis happens when one or both of the temporal arteries become swollen and inflamed. These arteries carry blood to your scalp, jaw, and eyes. When they are inflamed, blood flow can be restricted. This can cause serious complications, including blindness.
Doctors also call this condition giant cell arteritis or Horton disease. It is a form of vasculitis, which means inflammation of the blood vessels. It is considered a medical emergency because the risk of vision loss is real and can happen quickly.
According to the Mayo Clinic’s overview of giant cell arteritis, this condition is most common in adults over the age of 50. Women are affected more often than men. In Canada, it is considered a relatively rare condition, but it is important to recognize the signs early.
Who Gets Temporal Arteritis?
Temporal arteritis almost always affects older adults. It is rarely seen in people under 50. The average age at diagnosis is around 70 years old.
Women are roughly twice as likely to develop temporal arteritis as men. People of Northern European descent, including many Canadians, appear to have a higher risk. Researchers are still studying exactly why this is the case.
Furthermore, people who already have another condition called polymyalgia rheumatica face a higher risk. Polymyalgia rheumatica causes pain and stiffness in the shoulders, neck, and hips. If you or a loved one has this condition, speak with your family doctor about monitoring for signs of temporal arteritis.
Risk Factors to Know
Several factors can increase your chances of developing temporal arteritis. These include:
Age: Being over 50 years old significantly raises the risk.
Sex: Women are more commonly affected than men.
Ethnic background: People of Northern European descent have higher rates of this condition.
History of polymyalgia rheumatica: This condition is closely linked to temporal arteritis.
Family history: Having a close relative with temporal arteritis may increase your risk.
Symptoms of Temporal Arteritis
The most common symptom of temporal arteritis is a severe, throbbing headache. The pain is usually felt on one or both temples. It can feel constant or come and go throughout the day.
Many people also notice that their scalp feels tender to the touch. For example, brushing your hair or resting your head on a pillow might cause discomfort. This tenderness is a key warning sign that something is wrong with the arteries near your scalp.
However, headaches are not the only symptom. Temporal arteritis can cause a wide range of other symptoms, depending on which arteries are affected. It is important to take all of these signs seriously.
Common Symptoms Include
Severe, persistent headache, especially at the temples
Scalp tenderness or pain
Jaw pain or aching when chewing (called jaw claudication)
Fever and general feelings of being unwell
Fatigue and unexplained weight loss
Sudden, temporary vision changes or blurred vision
Double vision
Shoulder and hip stiffness or pain
Vision changes are the most urgent symptom to watch for. If you suddenly lose vision in one eye, even briefly, treat it as a medical emergency. Go to your nearest emergency room right away. Healthline’s guide on giant cell arteritis explains how vision loss can become permanent within hours if left untreated.
How Is Temporal Arteritis Diagnosed?
Diagnosing temporal arteritis requires a combination of blood tests and a small surgical procedure. Your doctor will start by reviewing your symptoms and doing a physical examination. They will likely feel along your temples to check for tenderness or abnormal texture in the artery.
A blood test is usually the first step. Doctors look for signs of inflammation in the blood, such as an elevated erythrocyte sedimentation rate (ESR) and elevated C-reactive protein (CRP). These are non-specific markers, meaning they show that inflammation is present somewhere in the body, but not exactly where.
The Temporal Artery Biopsy
The most reliable way to confirm temporal arteritis is through a temporal artery biopsy. In this procedure, a small piece of the temporal artery is removed and examined under a microscope. This is done under local anaesthetic, usually as a day procedure in a hospital or surgical centre.
The biopsy allows pathologists to look for giant cells, which are abnormal cells that form when the immune system attacks the artery wall. Finding these cells confirms the diagnosis. In Canada, this procedure is typically covered under your provincial health plan, though wait times may vary by province.
It is worth noting that treatment should not be delayed while waiting for a biopsy. If your doctor strongly suspects temporal arteritis based on your symptoms, they will likely start treatment right away. Starting corticosteroids does not significantly affect biopsy results if the procedure is done within a few weeks.
Imaging Tests
In some cases, doctors also use imaging to support the diagnosis. Ultrasound of the temporal arteries can show thickening and inflammation in the vessel walls. In some Canadian hospitals and specialist centres, MRI or PET scans may be used as well. These tests help doctors see how widespread the inflammation is.
Treatment for Temporal Arteritis
Treatment for temporal arteritis must begin as soon as possible. The main treatment is corticosteroids, most commonly prednisone. These are powerful anti-inflammatory medications that quickly reduce swelling in the arteries. Starting treatment promptly can prevent vision loss.
Doctors typically start with a high dose of prednisone. This high dose is maintained for several weeks until symptoms improve and blood markers return toward normal. After that, the dose is slowly reduced over many months or even years.
Long-Term Management
Because treatment lasts for a long time, monitoring is essential. Your doctor will regularly check your ESR and CRP levels to make sure the inflammation stays under control. If your levels rise again, the dose may need to be increased temporarily.
Long-term use of corticosteroids comes with its own risks. These include bone loss (osteoporosis), weight gain, high blood pressure, and increased blood sugar. As a result, your doctor will likely recommend bone-protective medications, regular blood pressure checks, and possibly a referral to a specialist such as a rheumatologist.
In recent years, a newer medication called tocilizumab (Actemra) has been approved to help treat giant cell arteritis. This medication can help patients reduce their corticosteroid dose more quickly, lowering the risk of long-term side effects. Talk to your doctor about whether this option is appropriate for your situation.
What to Expect During Recovery
Most people feel significant relief from headaches and other symptoms within a few days of starting corticosteroids. However, do not stop taking your medication just because you feel better. Stopping too early can cause a flare-up and increase the risk of vision loss or other complications.
According to Health Canada, managing chronic inflammatory conditions requires ongoing communication with your healthcare provider. Keep all follow-up appointments and report any new or returning symptoms right away.
Complications of Temporal Arteritis
The most serious complication of temporal arteritis is vision loss. When inflammation spreads to the ophthalmic artery, it can block blood flow to the retina or optic nerve. This can cause partial or complete blindness, often with little or no warning.
In addition to vision problems, temporal arteritis can affect larger blood vessels in the body. This is sometimes called large vessel vasculitis. It can involve the aorta (the main artery from your heart) and its branches. Over time, this can increase the risk of aortic aneurysm, a dangerous bulging of the aorta.
Furthermore, people with temporal arteritis have a higher risk of stroke. Inflammation in the arteries that supply the brain can increase the chance of a blood clot forming. This is another reason why early and consistent treatment is so important.
When to See a Doctor
If you are over 50 and experience a new, severe headache — especially with scalp tenderness, jaw pain, or any vision changes — see a doctor as soon as possible. Do not wait to see if it gets better on its own. Temporal arteritis is a medical emergency when vision is involved.
In Canada, you have several options for getting care quickly. If you experience sudden vision loss or double vision, go directly to your nearest hospital emergency department. If your symptoms are serious but not immediately threatening your vision, call your family doctor for an urgent appointment.
If you do not have a family doctor, a walk-in clinic can assess you and refer you to the appropriate specialist, such as a rheumatologist or ophthalmologist. Many provincial health plans cover these referrals. Check your province’s health authority website for information on accessing specialist care in your area.
Always consult a qualified healthcare provider before drawing any conclusions about your health. This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
Frequently Asked Questions About Temporal Arteritis
What are the first signs of temporal arteritis?
The first signs of temporal arteritis are usually a severe headache around one or both temples and scalp tenderness. Some people also notice jaw pain when chewing or feelings of fatigue and fever. If you experience sudden vision changes alongside these symptoms, seek emergency care immediately.
Can temporal arteritis cause blindness?
Yes, temporal arteritis can cause permanent blindness if it is not treated quickly. Inflammation can spread to the ophthalmic artery and cut off blood flow to the retina or optic nerve. This is why prompt treatment with corticosteroids is considered a medical emergency.
How is temporal arteritis diagnosed in Canada?
In Canada, doctors diagnose temporal arteritis using blood tests that check for inflammation markers like ESR and CRP, followed by a temporal artery biopsy. The biopsy is done under local anaesthetic and is typically covered by your provincial health plan. Imaging tests like ultrasound may also be used.
How long does treatment for temporal arteritis last?
Treatment for temporal arteritis typically lasts one to two years, though some people require treatment for longer. Doctors start with high-dose corticosteroids and gradually reduce the dose over many months. Regular blood tests are used to monitor inflammation and guide dosage adjustments.
Is temporal arteritis the same as giant cell arteritis?
Yes, temporal arteritis and giant cell arteritis refer to the same condition. Both terms describe inflammation of the temporal arteries caused by giant cells attacking the artery walls. The condition is also sometimes called Horton disease.
Who is most at risk for temporal arteritis?
People over 50 years of age are most at risk for temporal arteritis, with women being affected about twice as often as men. Those with a history of polymyalgia rheumatica or a family history of the condition also face a higher risk. It is more common in people of Northern European descent.
Key Takeaways
Temporal arteritis is inflammation of the temporal arteries, usually seen in adults over 50.
Women are more commonly affected than men.
Key symptoms include severe temple headaches, scalp tenderness, jaw pain, fever, and vision changes.
Vision loss is the most serious complication and can become permanent within hours.
Diagnosis involves blood tests and a temporal artery biopsy, both available through Canada’s provincial health system.
Treatment with high-dose corticosteroids must start immediately and continues for one to two years or more.
If you suspect temporal arteritis, contact your family doctor, visit a walk-in clinic, or go to an emergency room right away.
Always speak with a qualified healthcare provider for personal medical advice.
