Cerebellum

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

Department of Anatomy, Yonsei University College of Medicine

Cerebellum
Cerebellum

External
ExternalConfigurations
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
Cerebellum

External
ExternalConfigurations
Configurations

Subdivision of Flocculonodular Lobe

Nodulus

Flocculus

Subdivision of Anterior Lobe

Vermis
Lingula
Central Lobule

Hemisphere
Ala Central Lobule

postcentral fissure
Culmen

Quadriangular Lobule

Cerebellum
Cerebellum

External
ExternalConfigurations
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
Cerebellum

Internal
InternalConfigurations
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
Cerebellum

Internal
InternalConfigurations
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
Cerebellum

Internal
InternalConfigurations
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
Cerebellum

Internal
InternalConfigurations
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
Cerebellum

Internal
InternalConfigurations
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
Cerebellum

Classifications
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
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
Connections

Cerebellum
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
Connections

Cerebellum
Cerebellum

Connections
Connections

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

Main
MainConnections
Connectionsof
ofthe
theVestibulocerebellum
Vestibulocerebellum
Vestibular
Organ

Floculonodular
Lobe
VESTIBULAR NUCLEUS

Vermis

vestibulospinal tract
MLF

FASTIGIAL
NUCLEUS

lower motor neuron

LMN

ARCHICEREBELLUM

Main
MainConnections
Connectionsof
ofthe
the Paleocerebellum
Paleocerebellum

RED
NUCLEUS
rubrospinal
tract

NUCLEUS
INTERPOSITUS

Inferior
Olivry
Nucleus

lower motor neuron

SPINAL CORD

ANTERIOR
LOBE
PARAVERMAL
ZONE

PALEOCEREBELLUM

spinocerebellar tract

Main
MainConnections
Connectionsof
ofthe
theNeocerebellum
Neocerebellum

CEREBRAL
CEREBRAL
CORTEX
CORTEX

pyramidal
tract

lower motor neuron

LMN

THALAMUS
THALAMUS

Pontine
Pontine
Nucleus
Nucleus

DENTATE
DENTATE
NUCLEUS
NUCLEUS

POSTERIOR
POSTERIOR
LOBE
LOBE
CEREBELLAR
CEREBELLAR
HEMISPHERE
HEMISPHERE

NEOCEREBELLUM

Pyramidal
PyramidalTract
Tract and
andAssociated
Associated Circuits
Circuits

upper
uppermotor
motorneuron
neuron

UMN
UMN
BASAL
BASAL
GANGLIA
GANGLIA

Cerebellum
Cerebellum
pyramidal

tract

lower
lower motor
motor neuron
neuron

UMN
UMN

Cerebellum
Cerebellum and
andAutomatic
AutomaticMotor
Motor Control
Control
Motor
MotorCortex
Cortex

CEREBELLUM
CEREBELLUM
Red
RedNucleus
Nucleus

Reticular
Reticular
Formation
Formation

Vestibular
Vestibular
Nucleus
Nucleus

Lower
LowerMotor
MotorNeuron
Neuron(LMN)
(LMN)

Proprioceptors
Proprioceptors

Cerebellum
Cerebellum

Connections
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
Cerebellum

Connections
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 (C 1, C2, C3)
nucleus interpositus
Principal Inferior Olivary Nucleus
----------------- cerebellar hemisphere (D 1, D2)
dentate nucleus

caudal portion

rostral portion

medial and dorsal accessory olivary nucleus

Principal
Inferior Olivary
Nucleus

Cerebellum
Cerebellum

Function
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
Cerebellum

Clinical
ClinicalSyndromes
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.