Scalp necrosis in temporal arteritis: abrupt termination of the superficial temporal artery as a possible precursor

2013 ◽  
Vol 11 (6) ◽  
pp. 551-552
Author(s):  
Benjamin W.C. Sim ◽  
Tanya Karaconji ◽  
Gaurav Bhardwaj ◽  
Rahul Dubey ◽  
John P. Harris ◽  
...  
Keyword(s):  
Temporal Arteritis ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Scalp Necrosis

Polymyalgia rheumatica and temporal arteritis

2010 ◽  
pp. 3678-3683
Author(s):  
Jan Tore Gran
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Histological Examination ◽  
Polymyalgia Rheumatica ◽  
Temporal Arteritis ◽  
Superficial Temporal Artery ◽  
Granulomatous Inflammation ◽  
Temporal Artery ◽  
Unknown Aetiology ◽  
Inflammatory Conditions

Polymyalgia rheumatica and temporal arteritis are distinct but overlapping inflammatory conditions of unknown aetiology. They almost exclusively affect people over 50 years of age, women more than men (ratio 2–3:1), and particularly those of Nordic heritage. Temporal arteritis is characterized by granulomatous inflammation that penetrates all layers of the wall of medium and (often) large muscular arteries, in particular the superficial temporal artery. Histological examination of tissues from patients with polymyalgia rheumatica shows nonspecific changes only. The term ‘giant cell arteritis’ is properly used only to describe patients with biopsy-proven arteritis....

scholarly journals Scalp Necrosis Revealing Severe Giant-Cell Arteritis

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Safa Idoudi ◽  
Marouene Ben Kahla ◽  
Fares Mselmi ◽  
Badreddine Sriha ◽  
A. Guiga ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Carotid Arteries ◽  
Temporal Arteritis ◽  
Temporal Artery ◽  
The Elderly ◽  
Rare Occurrence ◽  
Irreversible Loss ◽  
Scalp Necrosis ◽  
Primary Vasculitis

Giant-cell arteritis (GCA), also referred to as temporal arteritis, is the most common primary vasculitis of the elderly involving the extracranial branches of the carotid arteries, in particular, the temporal artery. Patients usually present with temporal headaches, visual impairment, fever, and scalp tenderness. Scalp necrosis associated with GCA is a rare occurrence with approximately 100 cases reported in the literature to date. It is a therapeutic emergency requiring urgent management as it may lead to irreversible loss of vision. To increase awareness of this severe complication, we report a patient with a scalp necrosis revealing a GCA.

Endoscopically Assisted Harvesting of the Superficial Temporal Artery: Technical Note

Neurosurgery ◽  
2003 ◽  
Vol 52 (4) ◽  
pp. 982-985 ◽  
Author(s):  
Shigeki Kubo ◽  
Hiroshi Takimoto ◽  
Toshiki Yoshimine
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Hair Loss ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Small Incision ◽  
Endoscopic Method ◽  
Endoscopic Observation ◽  
Scalp Necrosis ◽  
Frontal Branch

Abstract OBJECTIVE We developed an endoscopic method for harvesting the superficial temporal artery (STA) through a small incision away from the artery. This method was used to harvest the frontal branch of the STA through an incision made along the parietal branch. METHODS A 7-cm linear incision is made along the parietal branch of the STA. After the parietal branch has been exposed, the frontal branch is accessed through the incision with the use of an optical retractor and a 4-mm endoscope. The frontal branch is harvested subcutaneously, under endoscopic observation. Both branches of the STA are anastomosed to the middle cerebral artery via a small craniotomy made through the incision. This method was used for six patients who presented with ischemic symptoms attributable to hypoperfusion in the middle cerebral artery area. RESULTS The frontal branch of the STA, measuring 6 to 8 cm, was harvested subcutaneously. The procedure required 30 to 60 minutes. The patency of the artery was verified with postoperative angiography. Hair loss or scalp necrosis was not noted for any patient. CONCLUSION Our experience demonstrates that the STA can be harvested through a small incision distant from the artery. Postoperative scalp necrosis and hair loss can be avoided. This less-invasive method expands the use of the STA in revascularization surgery beyond the limitations imposed by its anatomic course.

scholarly journals 17. Angiolymphoid hyperplasia with eosinophilia mimicking temporal arteritis

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ghazal Ansari ◽  
Angela Pakozdi ◽  
Oseme Etomi
Keyword(s):  
Temporal Arteritis ◽  
Conflicts Of Interest ◽  
Superficial Temporal Artery ◽  
Surgical Excision ◽  
Temporal Artery ◽  
Definitive Treatment ◽  
Temporal Artery Biopsy ◽  
Angiolymphoid Hyperplasia With Eosinophilia ◽  
Angiolymphoid Hyperplasia ◽  
Complete Surgical Excision

Abstract Introduction A 32-year-old man presented to rheumatology clinic with a 2-year history of progressively worsening right temporal headache, a painful hard lump on his right temple and pre-auricular tenderness not responding to conventional analgesics. Patient denied any jaw and tongue claudication. His vision was not compromised and patient denied weight loss, night sweats and arthralgia. He was fit and well otherwise. Case description Examination revealed a pulsatile mass with a length of 1 cm along the superficial temporal artery. Temporal artery ultrasound revealed lump corresponds to the superficial artery with thickened wall and halo formation raising the possibility of temporal arteritis. MRI head scan suggested inflammation of the superficial temporal artery. Discussion Because of the atypical features of young age and normal inflammatory markers, corticosteroid treatment was not commenced. A temporal artery biopsy showed no evidence of vasculitis, but revealed reactive lymphoid follicles with eosinophil infiltrates in the surrounding soft tissue. The diagnosis of angiolymphoid hyperplasia with eosinophilia (ALHE) was made. The patient’s headaches have completely resolved after the temporal biopsy. Unfortunately, three months later the lump and the headaches recurred. The symptoms improved with topical tacrolimus 0.1% ointment and he underwent for complete surgical excision of the lump. Patient is asymptomatic and remained well. Key learning points We present a case of angiolymphoid hyperplasia with eosinophilia which can mimic temporal arteritis presentation as in our case and has totally different approach to management.  ALHE, which is a benign, locally proliferative condition with predilection to the periauricular and scalp area with no definitive treatment however, complete excision can be curative. It may recur in up to one-third of cases in the absence of complete surgical excision as in our patient. Conflict of interest The authors declare no conflicts of interest.

Prolonged/delayed cerebral hyperperfusion in adult patients with moyamoya disease with RNF213 gene polymorphism c.14576G>A (rs112735431) after superficial temporal artery–middle cerebral artery anastomosis

2020 ◽  
pp. 1-8
Author(s):  
Ryosuke Tashiro ◽  
Miki Fujimura ◽  
Masahito Katsuki ◽  
Taketo Nishizawa ◽  
Yasutake Tomata ◽  
...  
Keyword(s):  
Genetic Analysis ◽  
Gene Polymorphism ◽  
Intracerebral Hemorrhage ◽  
Middle Cerebral Artery ◽  
Moyamoya Disease ◽  
Cerebral Artery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Adult Patients ◽  
Cerebral Hyperperfusion

OBJECTIVESuperficial temporal artery–middle cerebral artery (STA-MCA) anastomosis is the standard surgical management for moyamoya disease (MMD), whereas cerebral hyperperfusion (CHP) is one of the potential complications of this procedure that can result in delayed intracerebral hemorrhage and/or neurological deterioration. Recent advances in perioperative management in the early postoperative period have significantly reduced the risk of CHP syndrome, but delayed intracerebral hemorrhage and prolonged/delayed CHP are still major clinical issues. The clinical implication of RNF213 gene polymorphism c.14576G>A (rs112735431), a susceptibility variant for MMD, includes early disease onset and a more severe form of MMD, but its significance in perioperative pathology is unknown. Thus, the authors investigated the role of RNF213 polymorphism in perioperative hemodynamics after STA-MCA anastomosis for MMD.METHODSAmong 96 consecutive adult patients with MMD comprising 105 hemispheres who underwent serial quantitative cerebral blood flow (CBF) analysis by N-isopropyl-p-[123I]iodoamphetamine SPECT after STA-MCA anastomosis, 66 patients consented to genetic analysis of RNF213. Patients were routinely maintained under strict blood pressure control during and after surgery. The local CBF values were quantified at the vascular territory supplied by the bypass on postoperative days (PODs) 1 and 7. The authors defined the radiological CHP phenomenon as a local CBF increase of more than 150% compared with the preoperative values, and then they investigated the correlation between RNF213 polymorphism and the development of CHP.RESULTSCHP at POD 1 was observed in 23 hemispheres (23/73 hemispheres [31.5%]), and its incidence was not statistically different between groups (15/41 [36.6%] in RNF213-mutant group vs 8/32 [25.0%] in RNF213–wild type (WT) group; p = 0.321). CHP on POD 7, which is a relatively late period of the CHP phenomenon in MMD, was evident in 9 patients (9/73 hemispheres [12.3%]) after STA-MCA anastomosis. This prolonged/delayed CHP was exclusively observed in the RNF213-mutant group (9/41 [22.0%] in the RNF213-mutant group vs 0/32 [0.0%] in the RNF213-WT group; p = 0.004). Multivariate analysis revealed that RNF213 polymorphism was significantly associated with CBF increase on POD 7 (OR 5.47, 95% CI 1.06–28.35; p = 0.043).CONCLUSIONSProlonged/delayed CHP after revascularization surgery was exclusively found in the RNF213-mutant group. Although the exact mechanism underlying the contribution of RNF213 polymorphism to the prolonged/delayed CBF increase in patients with MMD is unclear, the current study suggests that genetic analysis of RNF213 is useful for predicting the perioperative pathology of patients with MMD.

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