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1 June 2014 Central Vestibular Disease in a Blue and Gold Macaw (Ara ararauna) With Cerebral Infarction and Hemorrhage
Claire Grosset, David Sanchez-Migallon Guzman, M. Kelly Keating, Patricia M. Gaffney, Linda Lowenstine, Allison Zwingenberger, Alex C. Young, Karen M. Vernau, Amberly M. Sokoloff, Michelle G. Hawkins
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Abstract

A 24-year-old female blue and gold macaw (Ara ararauna) was presented for an acute onset of left head tilt. On examination, the macaw was dehydrated and had a 120-degree left head tilt, decreased proprioception of the left pelvic limb, and intermittent vertical nystagmus. Results of hematologic testing and biochemical analysis revealed severe leukocytosis with lymphopenia and heterophilia and a high uric acid concentration. Radiographs showed bilateral intertarsal joint osteoarthritis and a healed ulnar fracture. Magnetic resonance imaging of the brain revealed focal T2 and fluid-attenuated inversion recovery hyperintense lesions in the right cerebral hemisphere and in the midbrain. The midbrain lesion showed susceptibility artifact on the T2* sequence, suggesting hemorrhage. In the T2* sequence, iron accumulation (as seen with hemorrhage) distorts the magnetic signal, resulting in the production of a susceptibility artifact, which can then be visualized as a region of hypointensity. The bird was hospitalized but died despite intensive care. Necropsy revealed multiple cerebral vascular lesions including an acute cerebral infarct, a ruptured midbrain aneurysm, and multifocal systemic atherosclerosis. To our knowledge, this is the first report of a cerebral aneurysm in a bird. This report correlates the clinical presentation, imaging, and histopathologic findings in a macaw with central vestibular disease and demonstrates how advanced imaging techniques can identify hemorrhagic lesions through the T2* sequence.

Claire Grosset, David Sanchez-Migallon Guzman, M. Kelly Keating, Patricia M. Gaffney, Linda Lowenstine, Allison Zwingenberger, Alex C. Young, Karen M. Vernau, Amberly M. Sokoloff, and Michelle G. Hawkins "Central Vestibular Disease in a Blue and Gold Macaw (Ara ararauna) With Cerebral Infarction and Hemorrhage," Journal of Avian Medicine and Surgery 28(2), 132-142, (1 June 2014). https://doi.org/10.1647/2012-069
Published: 1 June 2014
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