Giant-cell (temporal) arteritis following a bypass operation for cerebral infarction

A 61-year-old man was referred to us with linear and indurated erythemas and severe tenderness on the scalp, neck, tongue, and scrotum which had gradually spread over the previous six months. He had a history of an intracranial bypass operation for cerebral infarction. Histologic and ultrastructural examinations revealed giant-cell arteries in the skin as well as inflammatory cells infiltrating into nerves. Carotid angiograms indicated stenosis of cranial arteries. It is suggested that the bypass operation may be related to the occurrence of the giant-cell arteritis and that the inflammatory cell infiltrate into nerves may have caused the severe tenderness of this disease.