Cerebellum

Won Taek Lee, M.D. Ph.D.

Department of Anatomy, Yonsei University College of Medicine

Cerebellum

External Configurations

- located in posterior cranial fossa

- tentorium cerebelli (cerebrum), 4th ventricle (brain stem)
- communicate with other structure via
superior, middle, and inferior cerebellar peduncle
- longitudinal division
Vermis, Paravermal Region, Cerebellar Hemisphere
- transverse division
Anterior Lobe
------------ primary fissure
Posterior Lobe
------------ posterolateral fissure
Flocculonodular Lobe

Cerebellum

External Configurations

Subdivision of Flocculonodular Lobe

Nodulus

Flocculus

Subdivision of Anterior Lobe

Vermis

Hemisphere

Lingula
Central Lobule

Ala Central Lobule

postcentral fissure
Culmen

Quadriangular Lobule

Cerebellum

External Configurations

Subdivision of Posterior Lobe

Vermis

Hemisphere

Declive

Simple Lobule

postcentral fissure
Folium

Superior Semilunar Lobule

horizontal fissure
Inferior Semilunar Lobule

Tuber

Gracile Lobule

prepyramidal fissure
Pyramis

Biventer Lobule

secondary fissure
Uvula

Tonsil

Cerebellum

Internal Configurations

Cerebellar Cortex
Molecular Layer
Purkinje Cell Layer
Granular Layer

Corpus Medullare (Medullary Center)

Deep Cerebellar Nuclei
Fastigial Nuclei
Nucleus Interpositus
Emboliform Nucleus
Globose Nucleus
Dentate Nucleus

Deep Nuclei

1. fastigial
nucleus
2. globose
nucleus
3. emboliform
nucleus

4. dentate
nucleus

Cerebellum

Internal Configurations

Cerebellar Cortex
I. Molecular Layer
Stellate Cell --- taurine (inhibitory)
afferent: parallel fiber
efferent: Purkinje cell dendrite
Basket Cell ---- GABA (inhibitory)
afferent: parallel fiber
efferent: Purkinje cell soma

Parallel Fiber
granule cell axon

Purkinje Cell Dendrite

Cerebellum

Internal Configurations

Cerebellar Cortex
II. Purkinje Cell Layer
Purkinje Cell
-- 15,000,000 in number
-- GABA (inhibitory)
afferent: parallel fiber
climbing fiber
stellate cell
basket cell
efferent: deep cortical nuclei
Bergmans glial cell

Cerebellum

Internal Configurations

Cerebellar Cortex
III. Granular Layer
Granular Cell
-- 50,000,000,000 in number
-- glutamic acid (excitatory)
afferent: mossy fiber
efferent: Purkinje cell dendrite
basket cell, stellate cell
Golgi cell

Golgi Cell
-- GABA (inhibitory)
afferent: parallel fiber, mossy fiber rosette
efferent: granule cell dendrite

1. Purkinje cell
2. granule cell
3. basket cell
4. Golgi cell
5. stellate cell
6. climbing fiber
7. mossy fiber
8. parallel fiber
9. inferior olivary

nucleus
10. deep cerebellar
nuclei

Cerebellum

Internal Configurations

Synaptic Glomerulus
Afferent terminals on granular layer
Mossy Fiber Rosette
-- afferent fibers except
inferior olivary input
-- 2/3 of medullary center

Granular Cell Dendrite

-- main afferent input

Golgi Cell Axon

-- synapse on granule cell dendrite
-- GABA (inhibitory)
- Surrounded by Astrocyte Foot Process

Synaptic Glomerulus

Cerebellum

Classifications

Classification by Phylogenetic and Ontogenic Development

Archicerebellum
Paleocerebllum
Neocerebellum
Classification by Afferent Connection

Vestibulocerebellum
Spinocerebellum
Pontocerebellum
Classification by Efferent Connection

Vermis
Paravermal Region
Cerebellar Hemisphere

Archicerebellum
(nodulus)
Archicerebellum
(flocculus)
Paleocerebellum
Neocerebellum

Spinocerebellum

Pontocerebellum

Vestibulocerebellum

Cerebellum

Afferent Connections (1):

1. Inferior Cerebellar Peduncle

Restiform Body
Posterior Spinocerebellar Tract
Olivocerebellar tract
Cuneocerebellar Tract
Reticulocerebellar Tract

Juxtarestiform Body
Vestibulocerebellar Tract
Primary Vestyibular Fiber

Connections

Cerebellum

Afferent Connections (2):

2. Middle Cerebellar Peduncle
Pontocerebellar fiber
Corticopontocerebellar Fiber
Reticulocerebellar Fiber

3. Superior Cerebellar Peduncle

Anterior Spinocerebellar Tract
Cerulocerebellar fiber
Raphecerebellar fiber
Rubrocerebellar fiber
Hypothalamocerebellar fiber

Connections

Cerebellum
Efferent Connections :

1. Superior Cerebellar Peduncle

Cerebellothalamic fiber
- from 3 deep nuclei to VPLo, VLc, CL

Cerebellorubral fiber
- from nucleus interpositus
and dentate nucleus
ascending portion of
uncinate fasciculus of Russell

2. Inferior Cerebellar Peduncle

Fastigiovestibular fiber
descending portion of
uncinate fasciculus of Russell

Connections

Main Connections of the Vestibulocerebellum

Vestibular
Organ

Floculonodular
Lobe
VESTIBULAR NUCLEUS

Vermis

vestibulospinal tract
MLF

lower motor neuron

LMN

FASTIGIAL
NUCLEUS
ARCHICEREBELLUM

Main Connections of the Paleocerebellum

RED
NUCLEUS
rubrospinal
tract

NUCLEUS
INTERPOSITUS

Inferior
Olivry
Nucleus

lower motor neuron

SPINAL CORD

ANTERIOR
LOBE
PARAVERMAL
ZONE

PALEOCEREBELLUM

spinocerebellar tract

Main Connections of the Neocerebellum

CEREBRAL
CORTEX

pyramidal
tract

lower motor neuron

LMN

THALAMUS

Pontine
Nucleus

DENTATE
NUCLEUS

POSTERIOR
LOBE
CEREBELLAR
HEMISPHERE

NEOCEREBELLUM

Pyramidal Tract and Associated Circuits

upper motor neuron

UMN
BASAL
GANGLIA

Cerebellum
pyramidal

tract

lower motor neuron

UMN

Cerebellum and Automatic Motor Control

Motor Cortex

CEREBELLUM
Red Nucleus

Reticular
Formation

Lower Motor Neuron (LMN)

Vestibular
Nucleus

Proprioceptors

Cerebellum

Connections

Corticonuclear Connections
A zone ---------- fastigial nucleus
medial vestibular nucleus
B zone ---------- lateral vestibular nucleus
C1, C3 zone --- emboliform nucleus
C2 ---------------- globose nucleus

D1 ---------------- parvocellular portion of dentate nucleus

D2 ---------------- magnocellular portion of dentate nucleus

1. vermis
2. paravermal region
3. cerebella hemisphere
4. nodulus
5. flocculus
6. fastigial nucleus
7. globose nucleus
8. emboliform nucleus
9. dentate nucleus
10. medial vestibular nucleus
11. lateral vestibular nucleus

Cerebellum

Connections

Olivocerebellar Connections
Caudal portion of
medial and dorsal accessory olivary nucleus
----------------- vermis of cerebellar cortex (A and B)
fastigial nucleus
vestibular nucleus
Rostral portion of
medial and dorsal accessory olivary nucleus
----------------- paravermal region (C1, C2, C3)
nucleus interpositus
Principal Inferior Olivary Nucleus
----------------- cerebellar hemisphere (D1, D2)
dentate nucleus

caudal portion

rostral portion

medial and dorsal accessory olivary nucleus

Principal
Inferior Olivary
Nucleus

Cerebellum

Function

Maintenance of Equilibrium
- balance, posture, eye movement
Coordination of half-automatic movement of

walking and posture maintenace

- posture, gait
Adjustment of Muscle Tone
Motor Leaning Motor Skills
Cognitive Function

Balance

Motor Skill

Pablo Casals

Cerebellum

Clinical Syndromes

Ataxia: incoordination of movement

- decomposition of movement
- dysmetria, past-pointing
- dysdiadochokinesia
- rebound phenomenon of Holmes
- gait ataxia, truncal ataxia, titubation
Intention Tremor
Hypotonia, Nystagmus
Archicerebellar Lesion: medulloblastoma
Paleocerebellar Lesion: gait disturbance
Neocerebellar Lesion: hypotonia, ataxia, tremor

Posture
Gait Ataxia
Tremor

Cerebellar
Ataxia
Ataxic gait and position:
Left cerebellar tumor

a. Sways to the right in

standing position
b. Steady on the
right leg
c. Unsteady on the

left leg
d. ataxic gait

Cerebellar
Medulloblastoma
Cerebellar tumors on vermis
- Truncal Ataxia

- Frequent Falling
The child in this picture:
- would not try to stand
unsupported
- would not let go of the bed rail
if she was stood on the floor.