Giant cell arteritis with internal carotid artery stenosis and third nerve palsy: a case report

Volume : IV, Issue : IV, April - 2015

M. Moghaddasi, Faouzya Benaissa, N. Mohebi, L. Hashami, H. Karimian, A. Rast Manesh

 Background:

Giant cell arteritis or temporal arteritis is a necrotizing medium to large vessel arteritis of unknown etiology that was 

firstdescribed in 1932 by Horton. It commonly afflicts elderly people and may present with diverse manifestations such as severe headache, 

impairment of vision,ophtalmoplegia, polymyalgia rheumatica, tenderness of the temporal arteries, a highly elevated erythrocyte sedimentation 

rate (ESR) and a characteristic abnormal temporal artery biopsy.

Case report:

We report a 67–year–old man with new onset temporal headache, moderately elevated ESR, cranial nerves palsy, and high grade internal carotid 

artery stenosis, who was finally diagnosed as giant cell arteritis, although temporal artery biopsy was normal.

Discussion:

We conclude that, giant cell arteritis should be considered in all patients (even in those with ESR <50 and negative biopsy) presenting with third 

nerve palsy and temporal artery related symptoms or signs.