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Giant cell arteritis — SCE Neurology MCQ

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ModerateHeadacheGiant cell arteritisSCE Neurology

A 73-year-old woman presented with new temporal headache, jaw claudication and visual blurring in an older patient. On examination, temporal artery was tender and ESR was markedly raised. Initial investigations showed: fundoscopy suggested anterior ischaemic optic neuropathy. What is the most likely diagnosis?

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Correct answer: E — Giant cell arteritis

Giant cell arteritis is the best answer because the vignette describes Giant cell arteritis: GCA threatens sight and needs immediate high-dose glucocorticoids. Low-pressure headache is plausible in a neighbouring presentation, but the chronology, examination or investigation pattern does not match the key discriminator here. Cluster headache and Hypnic headache are less appropriate because they would require different localisation, timing or test findings; Cervicogenic headache would fit a different syndrome. Clinical pearl: migraine with aura would not cause jaw claudication or raised inflammatory markers.

Reference: NICE CG150; BASH headache guidance; BNF