19 Cerebral haemorrhage
INTRODUCTION
Haemorrhage into the nervous system may present as meningeal irritation causing neck pain or diffuse spinal pain. Lesions of the CNS may be multifocal or focal.
CASE HISTORY
One month prior to referral the hindlimbs gave way during exercise. Ataxia, circling and falling backwards were noted the following day. The dog recovered and had its first seizure the day before referral.
CLINICAL EXAMINATION
The dog was obtunded and ambulatory, circling to the left and had a left head turn (Fig. 19.1).
No ataxia was noted. The menace response was present bilaterally. Both pupils were miotic but a PLR could be detected bilaterally. The fundus looked normal.
Hopping, proprioception, and spinal reflexes were all normal. No spinal pain was found. The left upper lip was swollen and bruised (Fig. 19.2).
NEUROANATOMICAL DIAGNOSIS
The history of falling over backwards was suggestive of cerebellar disease but no sign of this was present on examination.
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