Temporal arteritis: features of the development of the disease and the main methods of treatment

Temporal arteritis (Horton's syndrome, vasculitis) is a chronic inflammatory disease of the vessels, in which a pathological change in the walls of large and medium arteries localized in the temporal lobe of the head the brain. Most often, the disease is diagnosed in elderly women, and with untimely treatment, the disease progresses with time to ischemia of the brain. Modern medication is not always able to cope with a rapidly developing disease, therefore, in most cases, vascular prosthetics is recommended.

Definition of disease

The disease was discovered and described in detail in 1932 by American rheumatologists under the guidance of Horton and Brown.However, the issue of the origin of the disease has not been fully studied so far, and effective conservative treatment methods have not been developed.

The main cause of the pathology is inflammation at the level of the aortic arch, which extends to the internal and external carotid arteries and their basins.

The disease occurs only in large and medium vessels, the capillaries are never subjected to pathology. It is proved that the inflammation of the artery arises not as a result of the entry into the blood of pathogenic microorganisms, but as an autoimmune reaction of the cells.Often, the pathogenic production of antibodies is provoked by a malfunction of the immune system after prolonged exposure to viruses and certain types of bacteria. As a result, antibodies developed to protect the body from foreign bodies are attached to the walls of the vessels, which leads to the development of a strong inflammatory process.

As the disease develops, inflammation foci appear on the artery, which are granulomas or cell clusters. Histological studies show that they consist of various blood cells - lymphocytes, eosinophils, plasma decay products, and giant multinucleated cells.

One of its many names - giant cell arteritis - the disease was due to the large number of giant multinucleated cells in the foci of inflammation.

As the disease develops, the walls of the vessels thicken, their surface becomes uneven.A large accumulation of blood decay products forms thrombi.Often not the entire surface of the aorta is affected, but only certain segments, usually located in the temporal artery.If the disease does not start on time, the granulomas begin to appear in the nearby blood vessels - the central artery of the retina, the carotid, subclavian, mesenteric arteries and others.

The most dangerous complication of temporal arteritis is the formation of aneurysms and ischemic disease of the brain, which often lead to death.

Causes

Despite the development of diagnostic methods of modern medicine, for today it is not known exactly what causes the pathological accumulation of blood bodies on the walls of the temporal artery. There are three most likely causes of the disease:

• Complication after various viral or bacterial infections. This is confirmed by the fact that in the granulomas and blood analysis of patients with arteritis of humans, markers in the form of antibodies and antigens developed during the infectious disease period are found. As a rule, it is a flu of various kinds, hepatitis, infection with staphylococcus;
• Genetic predisposition. As in the case of other diseases of the vascular system, a trend of hereditary transmission of arteritis has been revealed. This fact is confirmed by two facts. First, cases of diagnosing the disease in identical twins were recorded; secondly, temporal arteritis is found only in people with white skin color. According to statistics, Horton's syndrome is more often observed in the inhabitants of the Scandinavian region and North America;
• Autoimmune nature. Vasculitis has a characteristic feature of all autoimmune diseases - the body begins to attack itself, resulting in various pathologies. The stages of the development of the disease are similar to lupus, dermatomyositis and scleroderma.

In addition, it is common to distinguish two main forms of arteritis:

• Primary. The disease develops as an independent disease, usually in the elderly. The formation of granulomas in this case is rarely infectious;
• Secondary. Arteritis is a consequence of the complication of a viral or infectious disease, which took place in severe form.

There are several forms of vasculitis, which have characteristic features of development. For example, Behçet's disease is three times more common in men of adulthood, and Kawasaki syndrome is more often diagnosed in preschool children.

Symptoms

The development of the disease is characterized by an extensive clinical picture, which depends on the affected area and the form of the arteritis. All symptoms can be divided into three large groups:

• The signs characteristic of any inflammatory process:weakness and apathy, deterioration of appetite, hyperthermia, weight loss and increased sweating;
• Symptoms associated with localization of the disease:regular headache, tenderness in the palpation of the skin above the affected vessel, visual increase in the temporal artery;
• Numerous disruptions in brain function due to insufficient enrichment of structures oxygen: various visual pathologies, up to temporary or permanent loss of vision, increased intracranial pressure.

Among all the symptoms, the appearance of visual defects occurs much more often, which is explained by the localization of the disease near the temporal region of the brain.As the disease develops, inflammation of the arteries of the eye can occur, as well as damage to the central artery of the retina.This leads to a deterioration in visual acuity, the development of blindness. If the integrity of the vertebral arteries is affected, then diplopia (double vision in the eyes), as well as the descent of the upper eyelid - ptosis, may occur.

Temporal arteritis may be accompanied by a syndrome of rheumatic polymyalgia, in which the stiffness of the muscles and the traumatic pains during physical activity are felt.

Possible complications

If you do not start therapy on time, temporal arteritis can lead to very serious consequences. The formation of thrombi in the vascular system of the brain is a risk factor for the onset of ischemic stroke. With prolonged exposure to the walls of the vessels of the eyes, full or partial acquired blindness may develop.Plus, there is a risk of an aneurysm, which tends to rupture when jumping blood pressure and cause a hemorrhagic stroke.With the defeat of the main arteries of the brain there is a possibility of signs of discirculatory encephalopathy, which manifests itself in the form of mental disorders and suppression of cerebral circulation structures.

Treatment

Therapy is prescribed immediately if the patient has a characteristic symptom of the disease, since the disease is able to develop lightning fast.In the future, based on the diagnostic data, the treatment strategy may change. As a rule, only conservative and surgical methods of treatment are used.Folk remedies are completely useless in case of violation of patency of the blood vessels of the brain.

Medication Therapy

Like many other autoimmune diseases, treatment is based on the intake of hormonal drugs, usually based on glucocorticosteroids.In the early stages of the disease, prednisolone is particularly effective, its dosage and dosage scheme depends on the severity of the particular case.With the development of serious problems on the part of the visual system, it is recommended to switch to Methylprednisolone. On average, hormone therapy lasts from 6 months to 2 years, and if there are no improvements, then the question of a drug change or surgical shunting is raised. The use of medication is often accompanied by chemotherapy, which increases the chances of recovery several times.To remove the concomitant symptoms, various anti-inflammatory and anesthetic drugs, anticoagulants (more often heparin) are used.

When appointing hormonal means of prolonged use, it is necessary to take funds that support the work of the stomach and the bone system. Omeprazole and Nolpaz are most often used.

Surgical methods

To date, angioprotezings are used to treat temporal arteritis, and shunting is less common. This is a procedure for removing parts of the vascular system affected by the disease.The operation is performed under general anesthesia, and the choice of surgical methods depends on the location of granulomas in the artery.The main indications for the procedure - the presence of an aneurysm in the vessels of the brain, as well as a violation of blood supply to the eyeball.

.

How to remove the swelling of the upper eyelid

The causes of allergy on the eyes are described in this article.

How is astigmatism manifested? http://eyesdocs.ru/zabolevaniya/astigmatizm/kak-proyavlyaetsya.html

.

Prevention

Due to the autoimmune nature of the disease, there are no effective ways to prevent the development of the disease. However, restorative procedures, proper nutrition, adherence to the regimen of the day and rejection of bad habits are the most important factors for the health of blood vessels.The main condition for effective treatment is timely access to a specialist when symptoms are characteristic of the disease.In this case, the prognosis for complete recovery is much higher.

.

Eye drops Visoptik: instructions for use

Eye drops Broksinak with instructions are described in this article.

Drops for eyes from dryness and fatigue Blink Intensive http://eyesdocs.ru/medicinaoperacii/lekarstva/kak-i-dlya-chego-primenyayutsya-glaznye-kapli-blink-intensiv.html

.

Video

conclusions

Modern methods of medicine allow to detect in time, and then significantly improve the quality and life expectancy in the defeat of the cerebral arteries. Temporal arteritis or vasculitis is a severe autoimmune disease, the treatment of which sometimes turns into maintenance therapy for the rest of life. That's why doctors so strongly recommend to monitor their health, adhere to a healthy lifestyle, in order to reduce the risk of pathology from the vascular system.

Also read about such diseases as scotoma of the eye and nystagmus.