Arteritis of the extracranial carotid artery

The two forms of arteritis most likely to involve the extracranial carotid artery are temporal arteritis and Takayasu's arteritis. The two diseases have a similar histologic appearance, but different clinical presentations and patterns of arterial involvement. Steroid therapy is clearly indicated in temporal arteritis and is also beneficial in many patients with Takayasu's disease as well. Surgical reconstruction of the carotid artery is virtually never required in temporal arteritis, but is occassionally performed in patients with Takayasu's disease with excellent short- and long-term preservation of neurologic function. However, further work is clearly required to define the indications and appropriate technique for carotid reconstruction in patients with Takayasu's arteritis.