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Temporal artery biopsy
Category: Biopsies, Lab & Pathology Tests · All biopsies, lab & pathology tests
What it is
A temporal artery biopsy removes a short segment of the temporal artery (in the temple) under local anaesthetic to look for giant cell arteritis (GCA) — inflammation of arteries that can threaten vision. The tissue is examined for the characteristic inflammation.
Why it is done
It is performed when GCA is suspected — new headache, scalp tenderness, jaw pain when chewing, and raised inflammatory markers in someone over 50 — especially when the diagnosis remains uncertain after blood tests and ultrasound, since treatment (high-dose steroids) is long and significant.
How to prepare
Steroids are usually started immediately when GCA is suspected — do not wait for the biopsy, which remains informative for about two weeks after starting. Tell the surgeon about blood thinners and allergies. No fasting is needed.
What happens during the procedure
After numbing the temple skin, a cut along the hairline area exposes the artery; a segment (ideally 2 cm or more, as inflammation can skip sections) is removed and the ends tied. The wound is closed with stitches or adhesive. It takes about 30 to 45 minutes.
Afterwards — recovery & results
The wound heals over one to two weeks; bruising around the temple and eye can look dramatic but settles. Results take about a week. A positive biopsy confirms GCA; a negative one does not fully exclude it (skip lesions), so the rheumatology team weighs all the evidence for your steroid plan.
Risks & considerations
Risks include bleeding/haematoma, infection, a scar, and rarely injury to the facial nerve branch affecting forehead movement (the surgeon plans the incision to avoid it). Serious complications are uncommon.
Watch: Temporal artery biopsy videos
Real procedure videos from the MedicalVideos.com library. Some clinical footage is graphic — that is the nature of a medical video library.
Related guides on MedicalVideos.com
Frequently asked questions
Why biopsy if steroids are already started?
GCA treatment lasts a year or more with significant side effects; a positive biopsy secures the diagnosis for that journey, and it also protects against treating the wrong condition long-term.
Can ultrasound replace it?
Temporal artery ultrasound (the 'halo sign') is now first-line in many centres and can confirm GCA. Biopsy is still used when ultrasound is negative or equivocal but suspicion remains.
Related procedures — Biopsies, Lab & Pathology Tests
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