Raymond–Céstan syndrome

Medical condition

Raymond–Céstan syndrome
Other names	upper dorsal pontine syndrome,

Basillar artery runs down the middle(in above image) and blockage is cause of this condition. Diagram of the arterial circulation at the base of the brain (inferior view).
Diagnostic method	Cect/ncct brain, mri brain

Raymond–Céstan syndrome is caused by blockage of the long circumferential branches of the basilar artery.^[1] It was described by Fulgence Raymond and Étienne Jacques Marie Raymond Céstan.^[2] Along with other related syndromes such as Millard–Gubler syndrome, Foville's syndrome, and Weber's syndrome, the description was instrumental in establishing important principles in brain-stem localization.^[3]

Presentation

Ipsilateral ataxia and coarse intention tremor (damage to superior and middle cerebellar peduncle)
Ipsilateral paralysis of muscles of mastication and sensory loss in face (damage to sensory and motor nuclei and tracts of CN V)
Contralateral loss of sensory modalities in the body (damage to spinothalamic tract and medial lemniscus)
Contralateral hemiparesis of face and body (damage to corticospinal tract) may occur with ventral extension of lesion
Horizontal gaze palsy may occur (as in lower dorsal pontine syndrome)

Diagnosis

Treatment

References

^ http://www.clineu-journal.com/article/S0303-8467(07)00181-3/abstract
^ "Céstan-Chenais syndrome".
^ Silverman, IE; Liu, GT; Volpe, NJ; Galetta, SL (June 1995). "The crossed paralyses. The original brain-stem syndromes of Millard-Gubler, Foville, Weber, and Raymond-Cestan". Archives of Neurology. 52 (6): 635–8. doi:10.1001/archneur.1995.00540300117021. PMID 7763214. {{cite journal}}: Cite journal requires |journal= (help)

Kim, JS; Lee, JH; Im, JH; Lee, MC (Jun 1995). "Syndromes of pontine base infarction. A clinical-radiological correlation study". Stroke: A Journal of Cerebral Circulation. 26 (6): 950–5. doi:10.1161/01.STR.26.6.950. PMID 7762044.
Krasnianski, M; Neudecker, S; Zierz, S (Aug 2004). "[Classical crossed pontine syndromes]". Fortschritte der Neurologie · Psychiatrie (in German). 72 (8): 460–8. doi:10.1055/s-2004-818392. PMID 15305240. S2CID 144167622.

Cerebrovascular diseases including stroke

Ischaemic stroke

Brain	Anterior cerebral artery syndrome Middle cerebral artery syndrome Posterior cerebral artery syndrome Amaurosis fugax Moyamoya disease Dejerine–Roussy syndrome Watershed stroke Lacunar stroke
Brain stem	Brainstem stroke syndrome Medulla Medial medullary syndrome Lateral medullary syndrome Pons Medial pontine syndrome / Foville's Lateral pontine syndrome / Millard-Gubler Midbrain Weber's syndrome Benedikt syndrome Claude's syndrome
Cerebellum	Cerebellar stroke syndrome
Extracranial arteries	Carotid artery stenosis precerebral Anterior spinal artery syndrome Vertebrobasilar insufficiency Subclavian steal syndrome
Classification	Brain ischemia Cerebral infarction Classification Transient ischemic attack Total anterior circulation infarct Partial anterior circulation infarct
Other	CADASIL Binswanger's disease Transient global amnesia

Haemorrhagic stroke

Extra-axial	Epidural Subdural Subarachnoid
Cerebral/Intra-axial	Intraventricular
Brainstem	Duret haemorrhages
General	Intracranial hemorrhage

Aneurysm

Intracranial aneurysm
- Charcot–Bouchard aneurysm

Other

Signs and symptoms, and syndromes associated with lesions of the brain and brainstem

Cerebral cortex

ACA syndrome
MCA syndrome
PCA syndrome
Aphasia
Frontal lobe
- Expressive aphasia
- Abulia
Parietal lobe
Occipital lobe
Temporal lobe
- Cortical deafness
- Prosopagnosia

Subcortex

Basal ganglia
Thalamic syndrome

Cerebellum

Lateral
Medial
- Cerebellar ataxia

Brainstem

Medulla	Lateral medullary syndrome/Wallenberg PICA Medial medullary syndrome/Dejerine ASA
Pons	Upper dorsal pontine syndrome/Raymond–Céstan syndrome Lateral pontine syndrome (AICA) (lateral) Medial pontine syndrome/Millard–Gubler syndrome/Foville's syndrome (basilar) Locked-in syndrome Internuclear ophthalmoplegia One and a half syndrome
Midbrain	Weber's syndrome ventral peduncle, PCA Benedikt syndrome ventral tegmentum, PCA Parinaud's syndrome dorsal, tumor Claude's syndrome
Other	Alternating hemiplegia