A 65 year old lady underwent mastectomy for Carcinoma breast. Later she developed frontal headache, pain in temple region and around eye. Her ESR is 55 mm/hour. What is the most probable diagnosis?
**Core Concept**
The patient's symptoms, including frontal headache and pain in the temple region, are suggestive of a condition that involves inflammation and possible vascular damage. The elevated ESR (erythrocyte sedimentation rate) supports this notion, as it is a marker of inflammation.
**Why the Correct Answer is Right**
The patient's symptoms and elevated ESR are consistent with **Migraine or more likely Temporal Arteritis (Giant Cell Arteritis)**. Temporal Arteritis is a form of large vessel vasculitis that predominantly affects the branches of the external carotid artery, particularly the temporal artery. The inflammation of the temporal artery leads to headache, pain in the temple region, and visual disturbances. The elevated ESR is a non-specific marker of inflammation, but in the context of the patient's symptoms, it supports the diagnosis of Temporal Arteritis.
**Why Each Wrong Option is Incorrect**
**Option A:** While migraine is a possibility, the patient's age and the presence of an elevated ESR make Temporal Arteritis a more likely diagnosis.
**Option B:** Carcinomatous meningitis is a possibility in a patient with a history of cancer, but the symptoms and elevated ESR are more consistent with Temporal Arteritis.
**Option C:** Sinusitis could cause headache and pain in the temple region, but the elevated ESR and the patient's age make Temporal Arteritis a more likely diagnosis.
**Option D:** Cervicogenic headache could cause pain in the temple region, but the elevated ESR and the patient's age make Temporal Arteritis a more likely diagnosis.
**Clinical Pearl / High-Yield Fact**
Temporal Arteritis often presents in patients over the age of 50 and is associated with an elevated ESR. It is essential to consider this diagnosis in patients with headache, pain in the temple region, and visual disturbances, especially if they have a history of cancer or an elevated ESR.
**Correct Answer:** C. Temporal Arteritis (Giant Cell Arteritis)