00:01
Now, for a clinical correlation,
this clinical correlation relates
to the superficial temporal artery.
00:09
And there is a condition referred to
as superficial temporal arteritis.
00:14
In this condition, the superficial
temporal artery is going to be inflamed.
00:20
When it becomes inflamed,
it will have some associated symptoms.
00:26
One of the symptoms of
this inflammatory state
is a throbbing headache
on the involved site.
00:34
So here, we’re looking at the
left superficial temporal artery.
00:37
So if this is the
inflamed artery
then that throbbing headache
will be on the left side.
00:43
The other symptom that can be
associated with this clinical condition
is the scalp on the involved side
can have increased tenderness,
so it’s very sensitive to touch
because of the inflammatory state.
00:59
Temporal arteritis, also known as Giant
cell arteritis (GCA) or Horton disease
is a granulomatous inflammation
of large to small sized arteries
centered on the internal elastic
membrane causing fragmentation.
01:13
It most likely is mediated
by a T-cell immune response.
01:17
The cranial branches of arteries from the
aortic arch are most typically involved,
but the arteritis
can be widespread.
01:24
Women over 50 years of age are most
at risk with a peak at 70 to 79 years.
01:30
The female to male ratio is 2:1.
01:33
The most feared complication of
GCA is permanent loss of vision,
which is a common complication if
corticosteroids are not given early
when GCA is first suspected.
01:43
Early symptoms of GCA include transient
visual loss called Amaurosis fugax,
jaw claudication,
or fever and anemia
with increased levels of
Erythrocyte sedimentation rate (ESR)
and C-reactive protein (CRP).
01:59
The vision loss is
painless and sudden.
02:01
It can be partial or complete
and unilateral or bilateral.
02:06
Vision loss is usually due to occlusion
of the posterior ciliary artery,
which is the main arterial
supply to the optic nerve
and a branch of the ophthalmic artery
from the internal carotid artery.
02:18
This condition is called Arteritic
anterior ischemic optic neuropathy.
02:23
GCA often occurs with
polymyalgia rheumatica.
02:28
Another clinical correlation to be
aware of is carotid artery disease.
02:36
So in this particular clinical situation,
we’re looking at atherosclerotic build up.
02:45
If there is substantial
narrowing and then
ultimately complete stenosis
of the carotid artery,
that can result in
stroke symptoms.
02:58
So that could be a
thrombus that forms
that completely obstructs
the carotid artery system.
03:04
It might be an embolus that would then
occlude the atherosclerotic narrowing.
03:10
Some of the symptoms
then in this situation
could include sudden
numbness or weakness.
03:18
This would typically be
ipsilateral on the same side.
03:23
A patient may have
difficulty speaking.
03:27
There may be associated
visual disturbances.
03:32
There may be sudden, severe headaches,
again when this becomes very severe.