Raymond Céstan syndrome

Raymond Céstan syndrome, also known as Céstan–Chenais syndrome or upper dorsal pontine syndrome, is caused by blockage of the long circumferential branches of the basilar artery.^[1] It was described by Étienne Jacques Marie Raymond Céstan and Louis Jean Chenais.^[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]

Clinical features

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)

References

↑ http://www.clineu-journal.com/article/S0303-8467(07)00181-3/abstract
↑ http://www.whonamedit.com/synd.cfm/618.html
↑ 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.

Further reading

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.

Cerebrovascular diseases (G45–G46 and I60–I69, 430–438)

Brain ischemia/
cerebral infarction
(ischemic stroke/TIA)

TACI, PACI	precerebral: Carotid artery stenosis cerebral: MCA ACA Amaurosis fugax Moyamoya disease

POCI	precerebral: Anterior spinal artery syndrome Vertebrobasilar insufficiency Subclavian steal syndrome brainstem: medulla Medial medullary syndrome Lateral medullary syndrome pons Medial pontine syndrome/Foville's Lateral pontine syndrome/Millard-Gubler midbrain Weber's Benedikt Claude's cerebral: PCA Lacunar stroke Dejerine–Roussy syndrome cerebellar

General	cerebral: Cerebral venous sinus thrombosis CADASIL Binswanger's disease Transient global amnesia

Intracranial hemorrhage
(hemorrhagic stroke)

Extra-axial	Epidural Subdural Subarachnoid

Cerebral/Intra-axial	Intraventricular

Brainstem	Duret haemorrhage

Aneurysm

Cerebral aneurysm
- Intracranial berry aneurysm
- Charcot-Bouchard aneurysm

Other/general

Cerebral vasculitis

Lesions of spinal cord and brain

Spinal cord/
vascular myelopathy

sensory: Sensory ataxia
Tabes dorsalis

motor: Motor neurone disease

mixed: Brown-Séquard syndrome
cord syndrome (Posterior
Anterior
Central/Syringomyelia)
Subacute combined degeneration of spinal cord (B12)
Cauda equina syndrome

Anterior spinal artery syndrome

Brainstem

Medulla (CN 8, 9, 10, 12)	Lateral medullary syndrome/Wallenberg PICA Medial medullary syndrome/Dejerine ASA

Pons (CN 5, 6, 7, 8)	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 (CN 3, 4)	Weber's syndrome ventral peduncle, PCA Benedikt syndrome ventral tegmentum, PCA Parinaud's syndrome dorsal, tumor Nothnagel's syndrome Claude's syndrome

Other	Alternating hemiplegia

Thalamic syndrome

Other

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