Central vestibular disease in a blue and gold macaw (ara ararauna) with cerebral infarction and hemorrhage

Claire Grosset, David Guzman, M. Kelly Keating, Patricia M. Gaffney, Linda J Lowenstine, Allison Zwingenberger, Alex C. Young, Karen Vernau, Amberly M. Sokoloff, Michelle Hawkins

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)132-142
Number of pages11
JournalJournal of Avian Medicine and Surgery
Issue number2
StatePublished - 2014


  • aneurysm
  • Ara ararauna
  • atherosclerosis
  • avian
  • bird
  • blue and gold macaw
  • infarction
  • ischemic stroke
  • vestibular disease

ASJC Scopus subject areas

  • Small Animals


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