1. Cerebellum Won Taek Lee, M.D. Ph.D.
Department of Anatomy, Yonsei University College of Medicine

2. Cerebellum External 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

3. Cerebellum External Configurations
Subdivision of Flocculonodular Lobe
Nodulus Flocculus
Subdivision of Anterior Lobe
Vermis Hemisphere
Lingula
Central Lobule Ala Central Lobule
postcentral fissure
Culmen Quadriangular Lobule

4. Cerebellum External 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

6. Cerebellum Internal 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

7. Deep Nuclei
1. fastigial
nucleus
2. globose
3. emboliform
4. dentate

8. Cerebellum Internal Configurations
Cerebellar Cortex
I. Molecular Layer
Stellate Cell --- taurine (inhibitory)
afferent: parallel fiber
efferent: Purkinje cell dendrite
Basket Cell ---- GABA (inhibitory)
efferent: Purkinje cell soma
Parallel Fiber
granule cell axon
Purkinje Cell Dendrite

9. Cerebellum Internal 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
Bergman’s glial cell

10. Cerebellum Internal 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

11. 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

13. Cerebellum Internal 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

14. Synaptic Glomerulus

15. Cerebellum 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

16. Archicerebellum
(nodulus)
(flocculus)
Paleocerebellum
Neocerebellum

17. Spinocerebellum
Pontocerebellum
Vestibulocerebellum

18. Cerebellum Connections
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

19. Cerebellum Connections
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

20. Cerebellum 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

21. Main Connections of the Vestibulocerebellum
Vestibular
Organ
Floculonodular
Lobe
Vermis
VESTIBULAR NUCLEUS
vestibulospinal tract
MLF
FASTIGIAL
NUCLEUS
lower motor neuron
ARCHICEREBELLUM
LMN

22. Main Connections of the Paleocerebellum
RED NUCLEUS
NUCLEUS
INTERPOSITUS
rubrospinal
tract
Inferior
Olivry
Nucleus
ANTERIOR
LOBE
PARAVERMAL
ZONE
lower motor neuron
PALEOCEREBELLUM
SPINAL CORD
spinocerebellar tract

23. Main Connections of the Neocerebellum
CEREBRAL
CORTEX
THALAMUS
DENTATE
NUCLEUS
pyramidal
tract
Pontine
Nucleus
POSTERIOR
LOBE
CEREBELLAR
HEMISPHERE
lower motor neuron
NEOCEREBELLUM
LMN

24. Pyramidal Tract and Associated Circuits
upper motor neuron
UMN
Cerebellum
BASAL
GANGLIA
pyramidal tract
lower motor neuron
UMN

25. Cerebellum and Automatic Motor Control Lower Motor Neuron (LMN)
Motor Cortex
CEREBELLUM
Red Nucleus
Vestibular
Nucleus
Reticular
Formation
Lower Motor Neuron (LMN)
Proprioceptors

26. Cerebellum Connections
Corticonuclear Connections
A zone fastigial nucleus
medial vestibular nucleus
B zone lateral vestibular nucleus
C1, C3 zone --- emboliform nucleus
C globose nucleus
D parvocellular portion of dentate nucleus
D magnocellular portion of dentate nucleus

27. 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

28. Cerebellum 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
paravermal region (C1, C2, C3)
nucleus interpositus
Principal Inferior Olivary Nucleus
cerebellar hemisphere (D1, D2)
dentate nucleus

29. caudal portion rostral portion
Principal
Inferior Olivary
Nucleus
medial and dorsal accessory olivary nucleus

30. Cerebellum 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

31. Balance

32. Motor Skill
Pablo Casals

33. Cerebellum Clinical 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

34. Posture
Gait – Ataxia
Tremor

35. Cerebellar Ataxia a b c d 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 d

36. 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.