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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
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Cluster headache or giant cell arteritis?

Sangeetha Baskar1, Rolland Etti, George Kitas

  • 1Dudley Group of Hospitals, Rheumatology, Russel's Hall Hospital, Dudley, DY1 2HQ, UK. baskar@doctors.org.uk

BMJ Case Reports
|July 1, 2011
PubMed

Insights

This case highlights diagnostic confusion between giant cell arteritis and cluster headache in an elderly female. It emphasizes considering cluster headache in new or relapsing headaches, even in older women.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Headache Medicine

Background:

  • Giant cell arteritis (GCA) and cluster headache (CH) are distinct neurological conditions presenting with head pain.
  • Elderly patients, particularly women, are often underdiagnosed for certain headache disorders.

Observation:

  • An elderly female with polymyositis presented with new-onset temporal headache initially diagnosed as GCA.
  • The patient's subsequent clinical course was typical of cluster headache.

Findings:

  • This case demonstrates significant diagnostic overlap and potential confusion between GCA and CH.
  • Clinical presentation can be misleading, necessitating a broad differential diagnosis.

Implications:

  • Cluster headache should be considered in the differential diagnosis of new-onset or relapsing headaches in the elderly, including women.
  • Awareness of CH in elderly females is crucial, challenging historical perceptions of its lower prevalence in this demographic.
  • Accurate diagnosis is essential to guide appropriate management and prevent complications associated with misdiagnosis.

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