The generalized but patchy arteritis of the elderly which usually presents as temporal arteritis and which is characterized by a granulomatous reaction with giant cells adjacent to a damaged internal elastic lamina has been the subject of numerous communications in recent years. Its cause remains unknown. Apart from constitutional upset and rheumatic complaints, symptoms are due to the local effects of inflammation and to vessel narrowing which leads to impaired blood supply in the territory served by the affected artery. The areas to which the caroticovertebral system is distributed are the sources of typical symptoms. Occasionally, features arise due to ischemia elsewhere, the various possibilities being included in the most recent summary of the disorder by Paulley and Hughes (1960).
The apparent freedom from renal involvement has always seemed strange, particularly when temporal arteritis is compared with polyarteritis nodosa. It is for this reason that a case of proved temporal