Functional anatomy of the cerebellum

What is the functional anatomy of the cerebellum?

  • Three sagittal divisions: the left and right hemispheres and vermis. This segregation helps describe cerebellar syndromes

Cerebellar Syndromes

Clinical SyndromeRegion(s) InvolvedDistribution of DeficitsCommon CausesOther Features
Rostral vermisAnterior and superior vermis, includes fastigial nucleusWide-based stance
Gait ataxia with little ataxia on heel to shin
Normal or only slightly impaired arm coordination
Alcoholism (affects Purkinje cells)
Thiamine deficiency
Infrequent presence of hypotonia, nystagmus, and dysarthria
Caudal vermisSuperior vermis and flocculonodular lobeAxial disequilibrium, ataxic gait, and little or no limb ataxiaNeoplasm (e.g., medulloblastoma, especially in children)Sometimes spontaneous nystagmus and rotated postures of the head
Lateral zoneCerebellar hemisphereIpsilateral dysfunction:
Dysmetria
Dysdiadochokinesia
Hypotonia
Dysarthria
Excessive rebound
Ocular movement abnormalities
Lesions (e.g., infarct, neoplasm, abscess)Tremor if dentate nucleus involved
No balance or gait disorder
PancerebellarAll areasBilateral signs of cerebellar dysfunctionInfectious/parainfectious causes, toxic/metabolic, paraneoplastic cerebellar syndromes, hereditary cerebellar degenerations

Three transverse divisions correspond to major lobes, separated by fissures: the anterior, posterior, and flocculonodular lobes

  •  Three pairs of midline nuclei organized from medial to lateral are the fastigial, nucleus interpositus (containing the emboliform and globose nuclei), and the dentate nucleus.
  • • Three paired cerebellar peduncles contain the information flow to and from the cerebellum: the superior (a.k.a. brachium conjunctivum, SCP), the middle (a.k.a. the brachium pontis, MCP) and the inferior cerebellar peduncles (a.k.a. restiform body, ICP).
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