Headache is a common manifestation of Giant Cell Arteritis (GCA) NICE CG150, (Osiowski et al. 2025). GCA is a medical emergency, particularly due to the risk of sudden irreversible sight loss NICE CKS. It typically affects individuals aged 40 years and older NICE CKS.
Key clinical features suggesting GCA in a patient presenting with headache include the headache itself, which is often accompanied by other symptoms NICE CG150. These associated symptoms can include visual disturbances such as new visual loss (transient or permanent) or double vision NICE CKS,NICE CG150. Jaw claudication, which is pain in the jaw when chewing, is another characteristic symptom NICE CKS,NICE CG150. Other non-visual symptoms, such as a return of headache or jaw claudication, should prompt medical attention NICE CKS.
Supporting laboratory findings, though not definitive for diagnosis, often include an elevated C-reactive protein (CRP) level and an erythrocyte sedimentation rate (ESR) typically greater than 50 mm/hour NICE CKS. However, the ESR may be normal at presentation NICE CKS. Normochromic normocytic anaemia and an elevated platelet count are also common blood test abnormalities NICE CKS. A rapid response of symptoms to corticosteroids is usually observed in GCA; a poor response may suggest an alternative diagnosis NICE CKS.
Key References
- CKS - Giant cell arteritis
- CG150 - Headaches in over 12s: diagnosis and management
- NG228 - Subarachnoid haemorrhage caused by a ruptured aneurysm: diagnosis and management
- (Salvarani et al., 2012): Clinical features of polymyalgia rheumatica and giant cell arteritis.
- (Jodo and Hisada, 2013): Giant cell arteritis.
- (Osiowski et al., 2025): Headache as the most common manifestation of giant cell arteritis?: a systematic review with meta-analysis.