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This case report presents a 72-year-old female patient, Heloisa, who complained of a new daily persistent headache, which started 2 months before. The pain was in the temporoparietal region, throbbing, intense, constant, and progressive, with significant sensitivity in her scalp. In her laboratory tests, she had elevated ESR and C-reactive protein (CRP) levels. A Doppler ultrasound of the temporal, carotid, and vertebral arteries was normal, as well as a magnetic resonance angiography of the thoracic and abdominal aorta and their main branches. A 18F-FDG-PET of the whole body confirmed the diagnosis of giant cell arteritis (GCA). She was initially treated with prednisolone + methotrexate, and later with tocilizumab, achieving complete remission of symptoms and inflammation tests. This report emphasizes that one should always suspect GCA when a patient complains of a new headache that starts after the age of 50.

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Headache Attributed to Angiitis of the Central Nervous System: Giant Cell Arteritis

  • 章节

  • 发表日期：

    2026年

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  • Luiz Paulo Queiroz,
  • Andressa Miozzo Soares

摘要

This case report presents a 72-year-old female patient, Heloisa, who complained of a new daily persistent headache, which started 2 months before. The pain was in the temporoparietal region, throbbing, intense, constant, and progressive, with significant sensitivity in her scalp. In her laboratory tests, she had elevated ESR and C-reactive protein (CRP) levels. A Doppler ultrasound of the temporal, carotid, and vertebral arteries was normal, as well as a magnetic resonance angiography of the thoracic and abdominal aorta and their main branches. A 18F-FDG-PET of the whole body confirmed the diagnosis of giant cell arteritis (GCA). She was initially treated with prednisolone + methotrexate, and later with tocilizumab, achieving complete remission of symptoms and inflammation tests. This report emphasizes that one should always suspect GCA when a patient complains of a new headache that starts after the age of 50.