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Head tilt

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Abstract

Head tilt is characterized by a rotation of the median plane of the head along the axis of the body, resulting in one ear being held lower than the other. A head tilt often indicates a vestibular disorder and occurs as a result of the loss of antigravity muscle tone on one side of the neck. Head tilt must be differentiated from a head turn. This chapter covers diagnostic approach.

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Figures

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5.16.1 Severe right-sided head tilt in a Siamese cat caused by otitis media/interna.
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5.16.3 General diagnostic approach to head tilt and vestibular signs. BAER = brainstem auditory evoked response.
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5.16.4 Transverse T2-weighted MR image of a cat with right-sided loss of balance and postural reaction deficit and left-sided paradoxical head tilt caused by a meningioma. Note the severe compression on the right side of the cerebellum and brainstem.
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5.16.5 Transverse T2-weighted and T1-weighted contrast-enhanced MR images of a cat with left-sided otitis media/interna causing left-sided head tilt, facial nerve paralysis and Horner’s syndrome. On T2-weighted images, the left bulla contains tissue that is mostly hyperintense to neural tissue (arrow). The signal from the perilymph in the left inner ear (arrowhead) is reduced compared to the normal right inner ear. The contrast-enhanced image shows marked enhancement of the periphery of the left bulla (arrow) and left inner ear (arrowhead).

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