Temporal artery biopsy

temporal artery biopsy

Why would you have a temporal artery biopsy?

A temporal artery biopsy is done if a condition called giant cell arteritis is suspected. Giant cell arteritis causes the lining of the arteries to become inflamed and most often involves the temporal arteries. It can be associated with weight loss, pain, tenderness tot he scalp, difficulty chewing and a reduction in vision.

What kind of doctor does a temporal artery biopsy?

The biopsy is typically performed by an ophthalmic surgeon or a vascular surgeon. It is performed as a day case where you can go home the same day. It is also usually perfumed under local anaesthetic although you can have a sedate if you are anxious. 

Is a biopsy necessary for temporal arteritis?

Most cases require a single biopsy to confirm the diagnosis of giant cell arteritis. If the biopsy shows that an abnormal segment within the artery then this together with the symptoms and blood tests would be sufficient to confirm the diagnosis. There is always a possibility of the biopsy coming back normal or that the segment of artery biopsied is normal. The aim is for a 2cm segment to get a good enough sample.

How serious is temporal arteritis?

Giant cell arteritis or GCA classically affects the temporal arteries hence the name temporal arteritis. It can cause headache, jaw pain, scalp tenderness and visual problems. Left untreated it can lead to blindness, aortic aneurysm and stroke. 

How long does a temporal artery biopsy take?

The temporal artery biopsy procedure typically takes 1 hour to do. 

  • Your surgeon with feel the area of the temporal artery and mark it. They may also use a doppler ultrasound to determine the location of the artery. 

  • Some hair may need to be shaved to help identify the artery and reduce the risk of infection

  • The skin will be sterilised and a drape placed on the area.

  • Local anaesthetic is used to numb the area of the biopsy

  • An incision is made and the artery is located.

  • The sample is taken and the ends of the remaining artery are tied and sealed.

  • Stitches are used to close the skin and an ointment is applied. 

What are the risks of having a temporal artery biopsy?

The side effects of having a temporal artery biopsy are not common and include:

  • Infection to the surgical site

  • Scarring to the wound

  • Hair not regrowing on and around the scar

  • A scalp ulcer if there are problems to the blood circulation

  • An incorrect sample taken, an inconclusive result or need fr other biopsy

  • Nerve damage leading to numbness and weakness to the same side of the face

  • Stroke is a complication of GCA but there has been one case of this following biopsy.

How long can you live with temporal arteritis?

People with temporal arteritis or GCA that is treated can have a normal lifespan. A study in West Norway from 1972 to 2012 found no significant difference in survival rates in those with GCA and those without. 

Will temporal arteritis go away?

Temporal arteritis does not go away on its own. It can be treated with medication to prevent further damage any effect on blood flow. It is important to seek a diagnosis and treatment early and a biopsy for suspected GCA is considered an urgent procedure. 

Can temporal arteritis be cured?

Temporal arteritis can be treated with medication to prevent further damage to the arteries. There is no cure for temporal arteritis at the present time but treatment can be taken to prevent poor blood flow as a result of the condition. 

Will a brain MRI show temporal arteritis?

In some cases an MRI can show an abnormal blood flow through the temporal artery which would include the blood flowing slower than expected or the artery being occluded. The artery wall may enhance with the injection of a gadolinium contrast media. It is not as definitive in the diagnosis as a biopsy of the temporal artery.