Physical exam * Palpation of the head reveals prominent temporal arteries with or without pulsation. * The temporal area may be tender. * Decreased pulses may be found throughout the body * Evidence of ischemia may be noted on fundal exam. * Bruits may be heard over the subclavian and axillary arteries Intermediate magnification micrograph showing<unk>  in a temporal artery biopsy. The arterial lumen is seen on the left. A<unk> <unk>  is seen on the right at the interface between the thickened intima and media. H&E stain Laboratory tests * Erythrocyte sedimentation rate, an inflammatory marker, >60 mm/hour (normal 1–40 mm/hour). * C-reactive protein, another inflammatory marker, may be elevated. * LFTs, liver function tests, are abnormal particularly raised ALP- alkaline phosphatase * Platelets may also be elevated. Biopsy Histopathology of<unk> <unk>  vasculitis in a cerebral artery. Elastica-stain. The gold standard for diagnosing temporal arteritis is biopsy, which involves removing a small part of the vessel under local anesthesia and examining it microscopically for<unk> <unk> s infiltrating the tissue. However, a negative result does not definitively rule out the diagnosis; since the blood vessels are involved in a patchy pattern, there may be unaffected areas on the vessel and the biopsy might have been taken from these parts. Unilateral biopsy of a 1.5–3 cm length is 85-90% sensitive (1 cm is the minimum). A Characterised as intimal hyperplasia and medial granulomatous inflammation with elastic lamina fragmentation with a CD 4+ predominant T<unk>  infiltrate, currently biopsy is only considered confirmatory for the clinical diagnosis, or one of the diagnostic criteria. Medical imaging Radiological examination of the temporal artery with ultrasound yields a halo sign. Contrast-enhanced brain MRI and CT are generally negative in this disorder. Recent studies have shown that 3T MRI using super high resolution imaging and contrast injection can non-invasively diagnose this disorder with high specificity and sensitivity.
Giant cell arteritis
AL amyloidosis
Takayasu's arteritis
Stroke
Lupus headache
Medication overuse headache
Myofascial pain syndrome
Cluster headache