Résumé
Any new-onset headache in a subject >50 years raises the suspicion of giant cell arteritis (GCA). GCA may cause any type of headache, associated or not with other suggestive clinical features such as fatigue, fever, jaw claudication, temporal arteries abnormalities, shoulder and pelvic girdle pain, or visual alterations. The main risk is visual loss by anterior ischemic optic neuropathy. Diagnosis relies on clinical history (headache in a >50 years old), elevated ESR and CRP, and results of temporal artery biopsy. High-dose glucocorticosteroid therapy should be initiated immediately when clinical suspicion of GCA is raised, before the result of temporal artery biopsy if the clinical suspicion is high, in order to prevent complications. Efficacy of steroids is such dramatic that the persistence of headache after 4 days of treatment should prompt to consider an alternative diagnosis.