Health Insights · Rheumatology & autoimmune
Giant cell arteritis: a headache that needs urgent attention
Giant cell arteritis is inflammation of medium-sized arteries, typically those supplying the scalp and the eye. It occurs almost exclusively over the age of 50. Untreated it can cause sudden, permanent blindness — and once sight is lost it does not come back. Treated promptly, that outcome is almost always avoided.
Seek same-day assessment if you are over 50 with
- a new headache, usually one-sided and around the temple
- scalp tenderness — pain combing your hair or resting your head on a pillow
- jaw ache or tiredness when chewing that eases when you stop
- any change in vision, blurring, double vision or a curtain across your sight
- a tender, thickened or pulseless artery at the temple
- these symptoms alongside shoulder and hip girdle stiffness, fever or weight loss
Sudden visual loss is an emergency — go straight to an eye casualty or an emergency department. If sight is affected in one eye, the other is at risk within days without treatment. Steroid treatment is started immediately on clinical suspicion, before any test results, because waiting is what causes blindness. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
Why it is urgent
Inflammation narrows the arteries that supply the optic nerve. When one occludes, vision in that eye is lost suddenly and permanently, often without warning. Around a fifth of untreated people lose sight in one or both eyes. High-dose steroids started promptly reduce that risk dramatically, which is why treatment begins on suspicion rather than on confirmation.
The typical picture
- almost always over 50, and commoner over 70 and in women
- a headache different from any you have had before, often persistent and around one temple
- jaw claudication — aching in the jaw muscles on chewing — is the most specific symptom there is
- scalp tenderness, sometimes with a tender ropey artery you can feel
- fever, night sweats, weight loss, and profound fatigue
- in around half of cases, the shoulder and hip stiffness of polymyalgia rheumatica
Diagnosis
Blood tests showing raised inflammatory markers support the diagnosis but do not confirm it, and are occasionally normal. Confirmation is by temporal artery ultrasound or biopsy, ideally within a week of starting steroids — treatment should never be delayed for the test.
Treatment
- High-dose steroids, started immediately. Symptoms usually improve within 24 to 72 hours, which is itself a useful diagnostic sign.
- The dose is reduced gradually over 12 to 24 months. Flares are common if it is reduced too quickly.
- Do not stop steroids suddenly — this is dangerous. Carry a steroid card.
- Bone protection and monitoring for steroid side effects — blood pressure, glucose, weight, mood, cataracts — are part of proper care, not extras.
- Steroid-sparing treatments are used where the dose cannot be reduced or side effects are unmanageable.
Polymyalgia rheumatica
PMR causes severe stiffness and pain in the shoulders, neck and hips, at its worst in the morning and often making it hard to get out of bed or lift the arms. It responds dramatically to a much lower dose of steroid. It overlaps with giant cell arteritis, so anyone with PMR should know the headache and visual warning signs and act on them the same day.
This is one to be seen for quickly, and we can do that. We offer same-day appointments 7 days a week, with inflammatory markers and full blood tests taken in-house and results explained by a clinician, ultrasound performed on site, and rapid onward referral where a biopsy or specialist rheumatology input is needed. If you are over 50 with a new headache, jaw ache on chewing or scalp tenderness, do not wait for a routine appointment elsewhere.
Private giant cell arteritis assessment in East London
Giant cell arteritis is an inflammation of the arteries around the temples that mainly affects people over 50, and it needs urgent treatment because it can threaten sight. A new, severe headache with scalp tenderness, jaw ache on chewing, or any visual disturbance should be assessed the same day. A private GP in East London can examine you and arrange urgent blood tests (ESR and CRP) and start steroid treatment without delay, with our private rheumatology clinic in London confirming the diagnosis. Sudden loss of vision is an emergency — call 999 or go to A&E immediately. Tower Bridge Hospital is on Whitechapel Road in East London, a short journey from Canary Wharf and the City, with same-day appointments and no referral required.
Giant cell arteritis in London: common questions
Why is giant cell arteritis urgent?
Untreated, the inflammation can cause sudden, permanent sight loss, so suspected cases are treated straight away, often before every test is back.
What are the warning signs?
A new severe headache, tender scalp, jaw pain when chewing, and any visual change in someone over 50 — especially with a raised inflammatory marker.
How is it treated?
With steroids started promptly to protect vision, then careful reduction over time under rheumatology guidance.
Where do I go if my vision changes suddenly?
Sudden visual loss is an emergency — call 999 or go to A&E. For warning symptoms without visual loss, we can assess you the same day.
Same-day assessment and bloods in-house
7 days a week, 9am–7pm. Sudden visual loss needs emergency care.