Related Experiment Video
Updated: Oct 20, 2025
Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
Published on: August 15, 2025
Role of temporal artery resection in Horton's arteritis (Review)
Daniela Vrinceanu1, Mihai Dumitru1, Bogdan Banica1
1ENT Department, Emergency University Hospital, 010271 Bucharest, Romania.
Insights
Giant cell arteritis (GCA), also known as Horton's arteritis, involves inflammation of blood vessels. Temporal artery resection may offer diagnostic and potential therapeutic benefits for GCA patients, particularly for vision deficits.
Area of Science:
- Vascular Inflammation
- Rheumatology
- Ophthalmology
Background:
- Horton's arteritis, or giant cell arteritis (GCA), presents with diverse symptoms including headaches, jaw claudication, and visual disturbances.
- Pathogenesis involves an inflammatory cascade leading to granulomatous infiltrates in vessels, often affecting the temporal artery.
- Histopathology shows intimal thickening and transmural inflammation with giant cells.
Purpose of the Study:
- To review the diagnostic role of temporal artery resection in Horton's arteritis (GCA).
- To discuss the potential therapeutic benefits of temporal artery resection in managing GCA.
- To explore the impact of surgery on clinical symptoms and visual deficits.
Main Methods:
- Review of literature on temporal artery resection for Horton's arteritis (GCA).
- Analysis of clinical cases reporting symptom improvement post-surgery.
- Consideration of concomitant treatments, such as cortisone therapy.
Main Results:
- Temporal artery biopsy is crucial for diagnosing GCA.
- Some patients experienced significant improvement in vision and headache post-resection.
- The precise therapeutic contribution of resection alone is difficult to ascertain due to combined treatments.
Conclusions:
- Temporal artery resection plays a key diagnostic role in GCA.
- The procedure may have a therapeutic benefit, especially for visual symptoms, warranting further investigation.
- Further studies are needed to establish the independent therapeutic efficacy of temporal artery resection in GCA management.
Abstract:
Horton's arteritis is found in the literature under various names, such as temporal arteritis, Horton's disease senile arteritis, granulomatous arteritis or giant cell arteritis (GCA). The pathogenic mechanism is the result of an inflammatory cascade triggered by a still unknown factor that causes dendritic cells in vessels to recruit T cells and macrophages, which form granulomatous infiltrates. The clinical picture consists of a daily headache with temporal localization, with moderate to severe intensity, unilateral or bilateral, with a history of months, years. Other changes may include pain in the cheek or tongue during chewing (claudication), weight loss, generalized fatigue, low-grade fever, and frequent pain in the limbs, in the context of coexisting rheumatic polymyalgia. Visual symptoms represent a special category, involving blurred vision, scotomas, and even sudden blindness. Histopathological examination of the temporal artery biopsy reveals focal thickening of the intima, with interruption of the lamina propria, with transmural inflammatory infiltrates, sometimes with multinucleated giant cells. In this article, we aim to review the role of temporal artery resection in the diagnosis of Horton's arteritis, but we also discuss the hypothesis of a potential therapeutic benefit of this procedure. However, there are also clinical situations in which there has been a considerable improvement in clinical symptoms and especially in vision deficit, with the improvement of the visual field after surgery performed for biopsy. It is difficult to estimate the influence of temporal artery resection alone, given that most patients also have concomitant cortisone treatment. However, in some cases, the rapid improvement of symptoms immediately after surgery, with the improvement of visual acuity and visual field, along with the disappearance of the headaches, can create the premises for future studies on a therapeutic contribution of temporal artery resection in GCA.
