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Cerebellum Anatomy Relevant to Dizziness

Timothy C. Hain, MD Marcello Cherchi, M.D., Ph.D. Page last modified: February 28, 2017

This page is meant to provide a general outline of cerebellar function. It is adapted from a clinical neuroanatomy lecture given on a yearly basis to Northwestern PT students. This page is "under construction" and should not be relied upon.

Normal axial MRI
The cerebellum with surrounding skull and spinal fluid occupies the bottom 1/3 of this axial MRI image.

 

What is the cerebellum and what does it do ?

The cerebellum is part of the brain. It lies under the cerebrum, towards the back, behind the brainstem and above the brainstem. The cerebellum is largely involved in "coordination". Persons whose cerebellum doesn't work well are generally clumsy and unsteady. They may look like they are drunk even when they are not.

 

Gross Anatomy:

Cerebellar Hemispheres and Vermis

cerebellar hemispheres

http://www.benbest.com/science/anatmind/FigII8.gif

 

Gross Anatomy: Lobes & Lobules

Gross Anatomy: Fissures

Connections with brainstem:

cerebellar afferents

Afferent connections with spinal cord and brain

 

Cerebellar efferents
Cerebellar Efferents

Efferent connections

 

Sections of the Cerebellum

Vestibulocerebellum or archicerebellum

Spinocerebellum or paleocerebellum

Cerebrocerebellum or neocerebellum

CEREBELLAR PEDUNCLES

Cerebellar pathways

http://thalamus.wustl.edu/course/cerebell.html

 

Superior cerebellar peduncle (brachium conjunctivum)

 

Middle cerebellar peduncle (brachium pontis)

Inferior cerebellar peduncle (“corpus restiform” or “restiform body”)

Connects to medulla

Cerebellar Nuclei

cerebellar nuclei fastigial bleed

http://www.hallym.ac.kr/~de1610/nana/8-6.jpg

Cerebellar bleed into fastigial area. (MRI image is flipped to match anatomical orientation on left)

The patient associated with the right image above had a bleed into the area of her fastigial nucleus, blood filling her 4th ventricle, 3rd ventricle, and in ther lateral ventricles. This was decompressed surgically. From the picture above, certainly there could also be damage to several other deep cerebellar nuclei as well. Seven years later, she still had exotropia, inability to converge, horizontal saccadic dysmetria, some dysarthria, and gait ataxia. She had no spontaneous or positional nystagmus at all.

A movie of her eye is shown here. Note how the eye overshoots several times after returning to center.

Fastigial nucleus

Function:

 

Globose and emboliform (the “interposed nuclei”)

Dentate nucleus

The Dentate nucleus is part of the "triangle of Guillain Molleret" which is involved in oculopalatal myoclonus.

The triangle of Guillain-Mollaret -- Source: http://www.mni.mcgill.ca/neuroimage/

apr2001/apr2001_p7.htm

Another schematic of the triangle of Guillain-Mollaret -- source: http://www.neurology.org/cgi/content/full/71/4/301/F119. This view is a coronal view mainly showing the brainstem.

 

Vestibular nucleus

CEREBELLAR Histology:

cortical layers layer circuits

http://education.vetmed.vt.edu/Curriculum/VM8054

/Labs/Lab9/Examples/excereb.htm

http://www.anatomy.dal.ca/Human_Neuroanatomy/

handout%20gifs/cerebellum.jpg

 

Cortical Layers

Histology: Cell Types

Purkinje Cells

Largest cells in CNS (cell body = 60-90 µm in diameter)

Cell body

Dendrite

Axon

layers 2

http://www.mfi.ku.dk/ppaulev/chapter4/images/fp4-8.jpg

Granule Cells

granule cells

http://www.mona.uwi.edu/fpas/courses/physiology/neurophysiology/CerebellCellConnxns.JPG

 

1 x 1011 granule cells (more neurons than entire cerebral cortex!)

Cell body

Axon

Golgi Cells

Basket Cells

Stellate Cells

Cerebellar Circuits


Mossy Fiber System

Climbing Fiber System


Monoaminergic Fiber System

The monoaminergic projections to cerebellum send fibers to all three layers of cerebellar cortex.

Projections include:

 

 

Cerebellar Arterial Vasculature

brainstem arteries

SCA (superior cerebellar artery)

AICA (anterior inferior cerebellar artery)

PICA (posterior inferior cerebellar artery)

 

Clinical Correlates of Cerebellar disease

Postural instability

Maneuvers:

Other Clinical Correlates

dysdiadocho

http://medicine.tamu.edu/neuro/cerebell.htm

 

Errors in smoothness and direction of movement

Lack of coordination or synergy of movement (“decomposition” of complex movements)

Lack of motor plasticity or motor learning

Hypotonia

REFERENCES:

 

Copyright August 3, 2016 , Timothy C. Hain, M.D. All rights reserved. Last saved on August 3, 2016