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DIAGNOSIS/TREATMENT

■ CT or MRI to confirm presence of mass

■ Urgent neurosurgical evaluation

■ Dexamethasone if edema present on imaging or if severe symptoms

Temporal Arteritis

Temporal arteritis is an arteritis of small and medium-sized arteries that selec-

tively involves arterial walls with significant amounts of elastin. The disease

occurs predominantly in women and is rare in patients <50 years old.

SYMPTOMS/EXAM

■ Severe, throbbing, frontotemporal headache

■ Jaw claudication, systemic symptoms, or polymyalgia rheumatica may be

present.

■ Temporal artery may be nonpulsatile or tender.

DIAGNOSIS

■ Three of five criteria:

■ Age >50

■ New onset localized headache

■ Temporal artery tenderness or decreased pulse

■ Erythrocyte sedimentation rate >50 mm/hour

■ Abnormal arterial biopsy findings

NEUROLOGY

FIGURE 15.5. Noncontrast head CT demonstrating chronic subdural hematoma.

(Reproduced, with permission, from Aminoff MJ, Greenberg DA, Simon RP. Clinical

Neurology,6th ed. New York: McGraw-Hill, 2005:61.)