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Structure

Cerebellum

Not medically reviewed · Content last updated · 1 min read ·

This is the date the draft was written, not a medical review date.

The cerebellum coordinates movement, maintains posture and balance, and supports motor learning by comparing intended with actual movement. It does not initiate movement, and each hemisphere acts on the same side of the body.

Terminologia Anatomica (Latin): Cerebellum · Open in the 3D atlas

Location

In the posterior cranial fossa, behind the pons and medulla and beneath the tentorium cerebelli, forming the roof of the fourth ventricle.

Structure

A midline vermis and two hemispheres, divided into anterior, posterior and flocculonodular lobes. Three paired peduncles (superior, middle, inferior) connect it to the brainstem. Deep nuclei, from medial to lateral: fastigial, globose, emboliform and dentate.

Blood supply

Three paired arteries: superior cerebellar artery (from the basilar), anterior inferior cerebellar artery (AICA, from the basilar) and posterior inferior cerebellar artery (PICA, from the vertebral).

Innervation

Connections: afferents arrive mainly through the inferior peduncle (spinocerebellar, olivocerebellar, vestibular) and middle peduncle (pontocerebellar, from the cortex); efferents leave mainly through the superior peduncle (dentate to contralateral red nucleus and thalamus). Purkinje cells are the only cortical output and are inhibitory.

Function

The vestibulocerebellum (flocculonodular lobe) controls balance and eye movements, the spinocerebellum (vermis and intermediate zone) controls posture, gait and limb tone, and the cerebrocerebellum (lateral hemispheres) plans and times skilled movement.

Clinical correlations

Cerebellar lesions cause ipsilateral signs: ataxia, intention tremor, dysmetria, dysdiadochokinesia, nystagmus and scanning dysarthria; midline (vermis) lesions give truncal ataxia. Causes include stroke (PICA, AICA, SCA territories), tumour, alcohol and demyelination. Cerebellar haemorrhage or oedema may compress the fourth ventricle and cause hydrocephalus.

Common exam points

  • Cerebellar lesions produce ipsilateral signs (hemisphere to same side of the body).
  • Classic signs: ataxia, intention tremor, dysmetria, dysdiadochokinesia, nystagmus, dysarthria.
  • Three peduncles: superior (mainly efferent), middle (afferent from pons), inferior (afferent).
  • Deep nuclei from medial to lateral: fastigial, globose, emboliform, dentate.
  • Arterial supply: SCA, AICA and PICA; posterior fossa mass effect may cause hydrocephalus.

References

  1. Kandel ER, Koester JD, Mack SH, Siegelbaum SA. Principles of Neural Science. McGraw-Hill, 6th edition (2021) — Tier 3 (textbook)
  2. Haines DE, Mihailoff GA. Fundamental Neuroscience for Basic and Clinical Applications. Elsevier, 5th edition (2018) — Tier 3 (textbook)
  3. Drake RL, Vogl AW, Mitchell AWM. Gray's Anatomy for Students. Elsevier — Tier 3 (textbook)

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