[Indications for biopsy of the temporal artery]. / Indikationen zur Biopsie der Arteria temporalis.

Indications for Temporal Artery Biopsy are often discussed in the diagnosis of temporal arteritis. In this retrospective study we have reviewed the clinical records of 150 patients who underwent temporal artery biopsy between 1983 and 1990 in Kantonsspital Aarau/Switzerland. In 18.6% biopsies were histologically classified as temporal arteritis. To judge the indication for temporal artery biopsy the combination of symptoms leading to biopsy and the histologic results were compared. Symptoms were divided in unspecific, such as fever, loss of weight or malaise, and more specific symptoms as headache, jaw claudication, loss of visual acuity and diplopia, tenderness of temporal artery, or polymyalgia rheumatica. In conclusion the result of this study is that temporal artery biopsy may be an important help in the diagnosis of temporal arteritis in cases with one or two specific symptoms, at which polymyalgia rheumatica is a questionable indication. In our opinion temporal artery biopsy is not indicated in cases with isolated elevation of ESR, one or more unspecific symptoms and three or more specific symptoms, because there no diagnostic profit can be suspected.

[Cardiac myxoma with central retinal artery occlusion, hemiparesis and epileptic seizure in a 9-year-old patient]. / Kardiales Myxom mit Zentralarterienverschluss, Hemiparese und epileptischem Anfall bei einem 9jährigen Patienten.

A cardiac myxoma is a very rare cause for a central retinal artery occlusion (CRAO). We report the case of a nine-year-old boy who had an epileptic seizure, the computer-tomographically suspected diagnosis was intracerebral granulomas of unknown etiology. Five months later he suffered an acute hemiparesis and a CRAO. Through echocardiography the diagnosis of a cardiac myxoma was determined. This case shows the importance of the differential diagnosis "cardiac myxoma" in cases of central retinal artery occlusion in young patients especially with additional neurological disorders.