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Giant cell (temporal) arteritis is a granulomatous large-vessel vasculitis primarily affecting the extracranial branches of the carotid artery, especially the temporal artery.

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It is the most common systemic vasculitis in adults over 50 years, and early diagnosis is essential to prevent blindness.

https://www.youtube.com/watch?v=bHPEB9jjkf8

https://www.youtube.com/watch?v=VpxAHI3AYCo

https://www.youtube.com/watch?v=IFiru9qALA0

https://youtu.be/uknEYicaAuU

Key Features:

Feature	Description
Age group	>50 years (almost never in younger patients)
Sex	Female > Male (≈2:1)
Ethnicity	Most common in Caucasians, especially Northern Europeans
Pathogenesis	Autoimmune granulomatous inflammation, involving CD4+ T-cells, macrophages, and giant cells targeting arterial walls

Pathophysiology

Affects large and medium-sized arteries, particularly the temporal, ophthalmic, occipital, vertebral, and aortic branches.
Inflammation at the internal elastic lamina, leading to luminal narrowing, ischemia, and tissue infarction.
Giant cells are typically seen on histology but are not always present.

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Clinical features

![Clinical and laboratory signs and symptoms of giant cell arteritis with predominantly cranial symptoms

Bosch P, Espigol-Frigolé G, Cid MC, Mollan SP, Schmidt WA. Cranial involvement in giant cell arteritis. The Lancet Rheumatology. 2024;6(6):e384-e396. doi:https://doi.org/10.1016/s2665-9913(24)00024-9](attachment:d21d94ba-3718-46a7-849a-bd53366b71c7:gr2_lrg.jpg)

Clinical and laboratory signs and symptoms of giant cell arteritis with predominantly cranial symptoms

Systemic Symptoms	Cranial Ischemic Symptoms
Fever, fatigue	New-onset headache (temporal, occipital)
Malaise, weight loss	Scalp tenderness
Night sweats	Jaw claudication (most specific symptom)
Polymyalgia rheumatica (PMR) in ~50%	Amaurosis fugax or sudden vision loss (AION)
Elevated ESR/CRP	Diplopia, facial pain, tinnitus

Pathophysiology

Clinical features

Subclassification