Headache Can Cause Blindness: The Real Story of Giant Cell Arteritis That Many Don't Know

Headache Can Cause Blindness: The Real Story of Giant Cell Arteritis That Many Don't Know. Giant cell arteritis, also known as temporal arteritis, is a type of autoimmune inflammatory disease that attacks large blood vessels. Without immediate treatment, it can cause permanent blindness. Learn about the symptoms, causes, and treatment of this mysterious disease that is often mistaken for a regular headache.. First Act: A Headache Unlike Any Other Mr. Razak, a 65-year-old teacher, began experiencing a peculiar headache. Not the usual migraine or tension headache. This one was pulsating in the temples, as if something were pressing from within. He also complained of fever, fatigue, and body aches. "Maybe work stress," he thought. But when the pain persisted for more than two weeks and started affecting his vision, he had to go to the clinic. The doctor treating him suspected—these symptoms were not just a regular headache. It could be giant cell arteritis GCA , an inflammatory disease of large blood vessels that can lead to blindness if not treated promptly. What Is Giant Cell Arteritis? GCA, or temporal arteritis, is an autoimmune disease where the body's immune system mistakenly attacks the walls of large blood vessels, especially the temporal arteries located in the head and neck. This disease most commonly affects individuals over the age of 50, with the highest incidence among those aged 70-80 years. Women are at higher risk compared to men. In Mr. Razak's case, inflammation of the artery walls caused the blood vessel to swell, narrowing the space for blood flow and reducing oxygen supply to surrounding tissues, including the optic nerve of the eye. This threatened his vision. Confusing Symptoms GCA often mimics symptoms of other diseases, causing many patients to receive delayed treatment. Common symptoms include: - Pulsating or persistent headaches in the temple area - Sensitive scalp when touched - Jaw pain while chewing or speaking - Blurred vision, double vision double vision , or temporary blindness - Fever, weight loss, and extreme fatigue - Muscle and joint pain, especially in the shoulders, neck, and hips symptoms overlapping with polymyalgia rheumatica Mr. Razak experienced almost all these symptoms except blindness. Fortunately, he came early. Otherwise, the risk of permanent blindness would have been very high. Diagnosis: Finding the Clues Diagnosing GCA is not easy. Doctors will start with blood tests to measure the erythrocyte sedimentation rate ESR and C-reactive protein CRP —both are usually high in inflammation. However, these tests are not specific. The next step is imaging such as Doppler ultrasound, MRI, or PET scan to see the swollen artery walls. However, the gold standard for diagnosis is a temporal artery biopsy: taking a small sample of the artery under local anesthesia and examining it under a microscope. However, in about 10% of cases, the biopsy shows normal results even though the patient actually has GCA. Therefore, doctors need to combine all the information to make a decision. In Mr. Razak's case, his ESR and CRP were extremely high, and the ultrasound showed thickened artery walls halo sign . The biopsy then confirmed the presence of multinucleated giant cells—characteristic of this disease. The diagnosis was established. Treatment: High-Dose Steroids and Precautions Treatment for GCA must be started immediately after suspicion, without waiting for biopsy results. This is because every passing moment increases the risk of permanent blindness. The main drug is corticosteroids such as prednisolone or prednisone, given in high doses 40-60 mg per day for 2-4 weeks, then gradually reduced by 15% per month. The gradual reduction of the dose is important to avoid side effects such as osteoporosis, diabetes, high blood pressure, and infection risks. Mr. Razak started treatment with 50 mg of prednisolone daily. Within a week, his headache subsided, his fever disappeared, and his energy returned. However, the process of reducing the dose took months or even years. He had to undergo close monitoring by a rheumatologist to ensure the disease did not become active again. Life-Threatening Complications If left untreated, GCA can cause serious complications: - Permanent vision loss due to optic nerve ischemia - Aneurysms and aortic dissection—conditions that can be fatal - Stroke or transient ischemic attack - Jaw claudication jaw pain during chewing - Prolonged fever and drastic weight loss This is why patients are advised to go to the hospital immediately if they experience an unusual headache, especially if they are over 60 years old. Do not take it lightly. Epilogue: Living with GCA Mr. Razak is now in the maintenance phase of treatment. His steroid dose has been reduced to 10 mg per day, and he is still monitored every three months. He has learned to manage his health with a low-salt and low-sugar diet, light exercise, and stress control. "I am grateful for the early diagnosis. If not, I might be blind now," he said with a relieved tone. For GCA patients, early awareness and timely treatment are key to avoiding permanent disability. Do not let a regular headache cloud your vision of reality—sometimes, it is a signal that your arteries are fighting an enemy from within. --- Reference: Giant cell arteritis — Wikipedia https://en.wikipedia.org/wiki/Giant cell arteritis