Gurwood A S, Brilliant R, Malloy K A
Pennsylvania College of Optometry, Philadelphia, USA.
J Am Optom Assoc. 1998 Aug;69(8):501-9.
Giant cell arteritis is an enigmatic disease that is characterized by chronic granulomatous inflammation of the walls of large and medium-sized arteries. The process has a predilection for the extradural cranial arteries, which include the ophthalmic and the posterior ciliary arteries. A multisymptom disease of older individuals, giant cell arteritis often manifests challenging issues and diagnostic dilemmas.
We illustrate two cases with initial symptoms of intermittent headache, malaise, and decreased visual acuity that were incorrectly diagnosed or ultimately misdiagnosed. The first case represents a patient who was diagnosed as having migraine headache and an erythrocyte sedimentation rate (ESR) that was interpreted by the attending physician as too low to warrant temporal artery biopsy. The second case is that of a patient who had a history of headaches, jaw claudication, and numerous medical evaluations.
Giant cell arteries is an enigmatic disease with multiple manifestations. The differential diagnoses can range from temporal mandibular joint dysfunction to tension headache. Imminent vision loss as a sequelae of this condition warrants careful review of ocular and constitutional history and prompt treatment.
巨细胞动脉炎是一种神秘的疾病，其特征为大中型动脉壁的慢性肉芽肿性炎症。该病变过程易累及硬脑膜外的颅动脉，包括眼动脉和睫状后动脉。巨细胞动脉炎是一种好发于老年人的多症状疾病，常表现出具有挑战性的问题和诊断困境。
我们举例说明两例最初表现为间歇性头痛、不适和视力下降的病例，这些病例被错误诊断或最终误诊。第一例患者被诊断为偏头痛，其红细胞沉降率（ESR）被主治医生解读为过低，不足以进行颞动脉活检。第二例患者有头痛、颌部间歇性运动障碍病史，并接受过多次医学评估。
巨细胞动脉炎是一种具有多种表现的神秘疾病。鉴别诊断范围可从颞下颌关节功能障碍到紧张性头痛。作为该疾病后遗症的即将发生的视力丧失需要仔细回顾眼部和全身病史并及时治疗。
