USMLE Target 270 Dr.

Karun

Cerebellum
FA:

Kaplan: Anatomy, Cerebellar Cytoarchitecture, Circuitry, Cerebellar Lesions

Boards and Beyonds: Cerebellum

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USMLE Target 270 Dr. Karun

UWorld:

UWorld Notes:

Cerebellum:
Location: Posterior fossa
Consists of:
Vermis (Midline) *(Motor execution) 2 Cerebellar Hemispheres (planning)
Responsible for modulates axial/truncal posture and motor planning and coordination of the
coordination ipsilateral extremities
via their medial descending motor systems The lateral descending motor systems (eg,
connections with (eg, anterior corticospinal, reticulospinal, lateral corticospinal tract, rubrospinal tract).
vestibulospinal, and tectospinal tracts).
Lesion truncal ataxia (eg, wide-based, unsteadyIpsilateral
gait). a) dysdiadochokinesia (impaired rapid
alternating movements),
b) limb dysmetria (overshoot/undershoot
during targeted movement), and
c) intention tremor (tremor during targeted
movement).
Vertigo and nystagmus may also occur due to disruption of the inferior vermis and the flocculonodular lobe.

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USMLE Target 270 Dr. Karun

Case 01
A 55-year-old man comes to the office d/t progressive headaches over the past 2 months. The
headaches are throbbing, often associated with nausea, and worsen whenever the patient coughs or
bears down during a bowel movement. Medical history is significant for episodic migraine w/o aura. MRI
of the brain with gadolinium reveals a cystic mass, as shown in the image below:

Which of the following findings is most likely to be seen on physical examination of this patient?
A. Left dysdiadochokinesia (66%)
B. Left Horner syndrome (3%)
C. Left oculomotor nerve palsy (4%)
D. Photophobia (1%)
E. Right hemiparesis (8%)
F. Right hemisensory loss (3%)
G. Right homonymous hemianopia (8%)
H. Right lower facial droop (3%)

Q. Summary
An old man presents with progressive throbbing headache with worsens with Valsalva. Medical hx is
significant for episodic migraine w/o aura. MRI brain shows a cystic mass. What symptoms can be seen
in this pt.?
Ipsilateral dysdiadochokinesia