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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 Syndrome | Region(s) Involved | Distribution of Deficits | Common Causes | Other Features |
---|---|---|---|---|
Rostral vermis | Anterior and superior vermis, includes fastigial nucleus | Wide-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 vermis | Superior vermis and flocculonodular lobe | Axial disequilibrium, ataxic gait, and little or no limb ataxia | Neoplasm (e.g., medulloblastoma, especially in children) | Sometimes spontaneous nystagmus and rotated postures of the head |
Lateral zone | Cerebellar hemisphere | Ipsilateral 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 |
Pancerebellar | All areas | Bilateral signs of cerebellar dysfunction | Infectious/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).