Cerebellum ( Latin : Little Brain )

Dr. Izuchukwu
Okafor,
 PhD (UI/PAU) , PME (USA), CEART
(India)
 Lecturer, Anatomy Department ,
Nnamdi Azikiwe University

July 16, 2024 1

 Introduction

The cerebellum is the largest

part of the hindbrain
The cerebellum influences
movement on the ipsilateral
side of the body.
Although it weighs only 10 %
as much as the cerebral
cortex, its surface area is
about 75% of that of the
cerebral cortex .
It is connected to the
brainstem on each side by
the superior, middle and
inferior cerebellar peduncles
July 16, 2024
4th Ventricle 2
Cerebellar Peduncles : Carry afferents from where ?

Inputs to the Cereellum

lla r from the Cerebrum
e
ereb
r iorC ncle
pe u
Su Ped

Middle Cerebellar
Inputs to the Cerebellum
Peduncle from from the Pons

Inf
eri
or
Pe Cer
du eb
nc ell
le ar
Inputs to the Cerebellum
July 16, 2024 3
from the Medulla Oblongata
 LOCATION

It is s located in the posterior

cranial fossa

July 16, 2024

4th Ventricle 4
 RELATIONS

Anteriorly: 4th ventricle,

pons, and medulla oblongata
Superiorly: it is covered by
tentorium cerebelli
Inferiorly: occipital bone

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4th Ventricle 5
 EXTERNAL STRUCTURE

It consists of 2 cerebellar
hemispheres which are
interconnected by the vermis
in the center.

Surface shows parallel

running folds known as Folia.

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4th Ventricle 6
EXTERNAL STRUCTURE
Ithas anterior notch ,which is
wider and lodging the back of pons
& medulla. It is separated from
them by cavity of 4thventricle
 It has also posterior notch
occupied by falx cerebelli, which
separates the 2 cerebellar H.
Inferior surface : rounded
on each side and presents :
a deep groove (vallecula)
between the 2-cerebellar
hemispheres, which is occupied by
the inferior vermis. Tonsil is a
small part of cerebellar
Inferior surface
hemisphere that lies lateral to
External Structure of Cerebellum :
Superior surface : lies beneath
tentorium cerebelli and has a raised
superior vermis + a large cerebellar
hemisphere on each side + primary &
horizontal fissures.
1- Primary fissure V-
shaped, well defined fissure, lies on
superior surface and separates the small
anterior lobe from the larger middle lobe
(or posterior lobe).
2- Horizontal fissure lies along the
sides of cerebellum, extending from
anterior notch to posterior notch, separates
3- Secondary (posterolateral) fissure
the superior from the inferior surfaces.
lies on inferior surface and separates
flocculo-nodular lobe from the ramainder
of cerebellum.
July 16, 2024 9
 Anatomical Divisions of the
Cerebellum

Corpus Cerebelli ( main body of

cerebellum ) is divided into
Anterior and Posterior lobe by
Primary fissure.
Floculonodular Lobe lies behind
the posterolateral fissure
Two cerebellar hemisphere are
interconnected by the vermis.

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 Anatomical Divisions of the , & Flocculonodular Lobe Cerebellum :
Anterior Lobe , Posterior Lobe

The Primary Fissure divides the Corpus Cerebelli ( main body of

cerebellum ) into Anterior and Posterior lobes.
The Floculonodular Lobe lies behind the posterolateral fissure
Thw two cerebellar hemisphere are interconnected by the vermis.
July 16, 2024 11
Spinocerebellum ( medial
parts of hemispheres+
Vermis )
Neocerebellum
Lateral parts(
) of hemispheres

Hemisphere

Posterolateral Fissure
Flocculonodular Lobe

Physiologic ( Functional ) divisions of the

Cerebellum  Neocerebellum , Spinocerebellum
and Vestibulocerebellum
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 Functionally , the Cerebellum is divided into 3 parts :
Neocerebellum , Spinocerebellum , & Vestibulocerebellum
Neocerebellum
(cerebrocerebellum )
 Comprises the lateral portions of
cerebellar hemispheres.
 Is newest from a phylogenetic point of
view.
 It interacts with motor cortex in planning
& programming of movements.
The Neocerebellum is involved, in
conjunction with the cerebral cortex, in
planning & execution of skilled
movements.
It coordinate movements particularly of
the distal limb muscles (e.g., hand)
which are employed in skillful Anterior Lobe Spino-
movement. cerebellum
NB: the vermis projects to the
brainstem & control the movement of
axial and proximal limb muscle.

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Vestibulocerebellum
 The vermis projects to the brainstem areas
Spinocerebellum concerned with control of axial and proximal
( Paleocerebellum) limb movements .
 Consist of vermis & medial parts
NB : Whereas the Neocerebellum controls
of the cerebellar hemispheres . particularly distal limb muscles that are neede
 It receives  for skilled movements , the vemis controls
(1) Proprioceptive inputs (afferents ) movement of axial and proximal limb muscle
from all the body : Hence  It is which are mainly concerned with gross
concerned with regulation of . postural adjustments
muscle tone .
and it also receives 
(2) a copy of the “ Motor Plan “”from
the motor cortex
Therefore , by comparing plan with
performance , it acts as a “ Anterior Lobe Spino-
comparator “, and sends cerebellum
impulses back to the cortex to
correct movement  thereby it
coordinates & smoothens
ongoing body movements
July 16, 2024 14
Vestibulocerebellum
 Vestibulocerebellum
( Floculonodular Lobe):
 Phylogenetically , it is the oldest
part of the cerebellum ( hence it
is also called Archicerebellum )
 It has connections to the
vestibular nuclei , consequently ,
it is concerned with balance &
equilibrium
 And can induce changes in the
VOR Anterior Lobe Spino-
cerebellum
( Vestibulocular Reflex )

July 16, 2024 15

Vestibulocerebellum
 Cerebellar Organization
The cerebellum has grey matter areas
comprising the cerebellar cortex and
the deep cerebellar nuclei (DCN) .
They are separated from each other
by white matter (nerve fibers ).
The deep cerebellar nuclei are 4 in
number, & are called the:
(1) Dentate ,
(2) Globose ,
(3) Emboliform, &
(4) Fastigial nuclei .

The DCN are excited by both Mossy &

Climbing fibers, but are inhibited by
Purkinje cells

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 Cerebellar Cortex Efferents to the Deep Cerebellar Nuclei
Neocerebellar Cortex :
Projects (sends its efferents ) to the Dentate Nucleus 
& from there to the Ventrolateral Nucleus of the
Thalamus .
Spinocerebellar Cortex :
The Vermis projects to the Fastigial Nucleus  & from
there to the brainstem nuclei .
The hemispheric portions of the Spinocerebellum ( i.e.,
medial parts of the cerebellar hemispheres ) project to
the Emboliform and Globose nuclei  & from there to
the brainstem nuclei .
Vestibulocerebellar Cortex :
Its efferents pass directly to the brainstem ( & not via the
DCN)  to regulate balance , equilibrium & the VOR ).
Consequently , the Deep Cerebellar Nuclei provide the
only output of the Neocerebellum and Spinocerebellum .
July 16, 2024 17
 Layers of the Cerebellar Cortex
The cerebellar
cortex is made of
layers 
(1) External
Molecular layer ,

( 2) Middle
Purkinje Cell
layer that is only
one cell thick , &

(3) Internal
Granular layer

July 16, 2024 18

 Cells of
the
Cerebellar
Cortex

The cerebellar cortex contains 5 types of neurons : Purkinje , Granule ,

Basket , Stellate & Golgi cells .
(1) Purkinje Cells :
Are amongst the biggest neurons in the body .
Have very extensive dendritic arbors that extend throughout the Molecular
Layer .
Their axons , which are the only output from the cerebellar cortex, pass to
the deep nuclei .
July 16, 2024 19
 Granule Cells )2(
( Origin of Parallel Fibers )

Their cell-bodies are situated

in the Granular layer .
They receive input from the
Mossy fibers and innervate
the Purkinje cells .
Each sends an axon to the
Molecular layer , where the
axon bifurcates to form a T .
Granule
Because the branches of this
“ T ” are straight and run for cells
long distances , they are
called Parallel Fibers .

July 16, 2024 21

 Granule Cells ( continued )
Because the
dendrites of
Purkinje cells are
oriented at right
angles to the
Parallel fibers
(which are ,
actually , axons of
Granule cells ) 
Each parallel fiber
makes synaptic
contacts with the
dendrites of many Granule cells
Purkinje cells ,
July 16, 2024 22
 And thus the
parallel fibers and
Purkinje cell
dendritic trees
form a grid of
remarkably
regular proportions

July 16, 2024 23

 The other 3 types of neurons in the cerebellar cortex are
inhibitory neurons :
(3) Basket cells ( inhibitory to Purkinje ):
Are located in the Molecular layer
They are excited by Parallel fibers of Granule cells , &
their output inhibits Purkinje cell discharge by a process
of Feed-Forward Inhibition.
Their axons form a basket around the cell-body and
axon hillock of each Purkinje cell they innervate .
(4) Stellate cells (inhibitory to Purkinje ):
Similar to Basket cells  they are excited by Parallel
fibers of Granule cells , & their output inhibits Purkinje
cell discharge by a process of Feed-Forward Inhibition .
They differ from Basket cells only in being more
superficially located in the cortex than Basket cells .

July 16, 2024 24


Golgi cells are located in the Granular
layer .
Their dendrites, which project into the
Molecular layer , receive inputs from
the Parallel fibers .
Their cell bodies receive input via
collaterals from the incoming Mossy
fibers and the Purkinje cells
July 16, 2024
Golgi cells )5(
Their axons project to inhibit the
dendrites of the Granule cells .
They are excited by
(1) Mossy fibers
(2) Purkinje cells, &
(3) Parallel fibers (of Granule cells ).
They inhibit the excitatory action
of Mossy fibers on Granule cells .
25
 The Main Inputs
(Afferents ) to the Cerebellar
Cortex (1)

There are 2 main inputs to the

cerebellar cortex: the Climbing
Fibers and Mossy Fibers, both of
which are excitatory .
Climbing Fibers :
The climbing fibers come solely
from the Inferior Olivary Nucleus
They provide an indirect
proprioceptive input to the
cerebellar cortex  bringing to it
proprioceptive information from all
parts of the body via relays in the
Inferior Olive (which receives Each climbing fiber projects to
proprioceptive inputs from all over the dendrites of Purkinje cells ,
the body parts ) around which it entwines like a
climbing plant .
July 16, 2024 26
 The Main Inputs
(Afferents ) to the Cerebellar Cortex (2)

Mossy Fibers :
(1) These, unlike Climbing Fibers
(which provide an indirect
proprioceptive input ) do provide a
direct proprioceptive pathway
(input) to the cerebellar cortex,
from all parts of the body, and in
addition
(2) Provide inputs from the Motor
Area (M1) & related areas of the
Cerebral Cortex (indirectly, via
relays in the pontine nuclei).
They end on the dendrites of
Granule cells in complex synaptic
groupings called Glomeruli .
The Glomeruli also contain the
inhibitory endings of the Golgi
cells.

Climbing Fibers Mossy Fibers

July 16, 2024 27
 Corollary ( summary ) of effects of different cells &
afferents on Purkinje cells
(A) Excitatory
The fundamental circuits of cerebellar cortex are thus relatively simple :
(1) climbing fiber inputs exert a strong excitatory effect on single Purkinje
cells, whereas
(2) Mossy fiber inputs exert a weak excitatory effect on many Purkinje cells
via the Granule cells .
(B) Inhibitory
(1) Basket cells Both are excited by Parallel fibers of Granule
(2) Stellate cells cells , & their output inhibits Purkinje cells
( Feed-Forward Inhibition ) .
(3) Golgi cells 
Golgi cells are excited by
(1) Mossy fibers
(2) Purkinje cells , &
(3) Parallel fibers .
– They inhibit the action of Mossy fibers on Granule cells

July 16, 2024 28

Q : What are the Neurotransmitters Secreted by in
? the Cerebellar Cortex Neurons

Purkinje cells
Basket cells
Stellate cells Secrete GABA
Golgi cells

Granule cells  Glutamate

July 16, 2024 29

 Functional Significance of Cerebellar Cortex
Circuitry
The DCN are excitatory to the Brainstem nuclei & Thalamus .
The circuitry of the Cerebellar Cortex seems to be solely concerned
with modulating the

(1) Timing of the excitatory action of the DCN on the Brainstem &
(2) strength Thalamus

Remember that : The DCN are excited by both Mossy & Climbing
fibers, but are inhibited by Purkinje cells .
Hence activity in Mossy & Climbing fibers excite the DCN .
But DCN are also excitatory to Purkinje cells which inhibit the DCN .
Thus the effect of the afferent inputs seems to activate the DCN
initially , & then , after a latency of time (of a few ms perhaps), to
switch them off via exciting the Purkinje cells (remember that more
synapses  mean more latency ) .

July 16, 2024 30

 The Primary Afferents that Converge to Form the Mossy Fiber or Climbing Fiber
,Inputs to the Cerebellum
Afferent Tract : Transmits Information About
Pontocerebellar Intended movements from M1 and other parts of cerebral
cortex related to initiation & execution of voluntary
movement (indirect path , via relays pontine nuclei )
Ventral and Dorsal Proprioceptive information from muscles , tendons &
(Ventral & Dorsal ) joints in the trunk & limbs
( direct paths)
Cuneocerebellar Proprioceptive information from muscles , tendons &
joints in the head and neck
(direct paths)
Olivocerebellar Proprioceptive information from whole body (indirect
path , via relay in inferior olive )
Tectocerebellar Visual (from retina ) & Auditory ( from Cochlea )
information (via Superior & Inferior Colliculi )
Vestibulocerebellar Body position in space from Inner Ear Vestibular
Apparatus ( directly from the labyrinth + Indirectly via
July 16, 2024 vestibular nuclei ) 31
 Summary of Connections & Functions
Deep Cortex Inputs Outputs Function
Nuclei

Neo- Dentate Lateral portions Corticoponti Superior Planning and

cerebellum of Cerebellar ne/ cerebellar executive of
Hemisphere pontocereb Peduncle voluntary &
ellar (SCP) to skilled hand
VA/VL movements

Spino- Interpos Vermis & Medial Spinal and SCP to Muscle tone ,
cerebellum ed; portions of brainstem Red posture &
Fastigial Cerebellar paths Nucleus; coordination of
hemispheres Fastigial movements
to
Reticular
Formation
(RF)

Vestibulo- Fastigial Flocculonodular Vestibular Vestibular Balance ,

cerebellum nuclei nuclei; RF equilibrium &
VOR
July 16, 2024 32
 Remember
Cerebellum hemispheres control the same (ipsilateral)
side of the body .
Purkinje cells are the main output neurons of the
cerebellar cortex & project to the deep nuclei of the
cerebellum.
Purkinje and mossy fibres are inhibitory to the DCN.
The deep cerebellar nuclei (DCN) project out to
brainstem and thalamic targets via the superior
cerebellar peduncles. They are excitatory, but in turn,
are themselves inhibited (switched off) by Purkinje cells .
Flocculonodular lobe is important for regulation of
balance , equilibrium & the VOR .

July 16, 2024 33

Blood supply
• Posterior inferior cerebellar
artery
• Anterior inferior cerebellar
artery
Branch of basilar artery
• Superior cerebellar artery
 CLINICALS

July 16, 2024 35

 Cerebellar Lesions
 Are usually vascular, may be traumatic or tumour.
 Manifestations of unilateral cerebellar lesions :
1-ipsilateral incoordination of (U.L) arm = intention tremors : it
is a terminal tremors at the end of movement as in touching nose or
button the shirt.
2-Or ipsilateral cerebellar ataxia affects (L.L.) leg, causing
wide-based unsteady gait.
 Manifestations of bilateral cerebellar lesions (caused by alcoholic
intoxication, hypothyrodism, cerebellar degeneration & multiple
sclerosis) :
1-dysarthria : slowness & slurring of speech.
2-Incoordination of both arms.= intention tremors.
3-Cerebellar ataxia : intermittent jerky
movements or staggering , wide-based, unsteady gait.
4-Nystagmus : is a
very common feature of multiple sclerosis. It is due to impairment
coordination of eye movements /so, incoordination of eye movements
occurs and eyes exhibit a to-and-fro motion.
 Combination of nystagmus+ dysarthria + intension tremors constitutes
Clinical application
• Lesion of floccolonodular lobe leads to disequilibrium.
• Lesion of cerebropontine connections leads to hypotonia,
diminished muscle jerk, intention tremor, clumsy
movements
• Isolated lesions of the vermis are produced in children by
medulloblastomas in the roof of the fourth ventricle
Clinical application
• Anterior lobe lesions leads to ataxia
• Dysdiadochokinesia: inability to perform alternating
movements regularly and rapidly
• Dysarthria occurs in cerebellar disease because of ataxia
of the muscles of the larynx
 DETAILS ON
Cerebellum Lesions

July 16, 2024 39

 Cerebellar Hemispheric Lesions

Cerebellar lesions cause no paralysis or sensory deficit .

When not moving , there are no externally obvious signs.
However, upon physical examination, signs such as
hypotonia and pendular reflexes can be elicited.
Once the patients attempts movement , ataxia appears .
What is ataxia? Ataxia is incoordination of due to errors
in the rate, range, force and direction of movement .
With circumscribed lesions, the ataxia may be
confined/localized to only one part of the body .

July 16, 2024 40

 The Difference Between Lesions of the
Cerebellar Cortex & Lesions of DCN
If only the cortex of the cerebellum is involved ,
the movement abnormalities gradually disappear
as “ compensation ” occurs .
However, lesions of the DCN produce more
generalized defects, and abnormalities are
permanent.
For this reason , care should be taken to avoid
damaging the DCN when surgery is undertaken
to remove a tumor involving part of the
cerebellar cortex .

July 16, 2024 41

 Hemispheric Lesions
Ataxia (lack of coordination of muscle movement ) ,
which is manifested by 
(1) Wide-based, unsteady “ drunken , or staggering “
gait .
(2) Scanning speech
(3) Dysmetria (also called Past-Pointing ) : attempting
to touch an object with a finger results in overstretching
to one side or the other this promptly initiates a gross
correction action (corrective action ) , but the correction
overshoots to the other side  Consequently , the
finger oscillates back and forth .
This oscillation is the (4) “ Intention Tremor ”, which is
characteristic of cerebellar disease .
This cerebellar tremor, unlike that of Parkinson’s
disease, is absent at rest .

July 16, 2024 42

 Hemispheric Lesions ( Contd )
Inability to “ put on the brakes ”  i.e., inability to stop movement
promptly. Normally, for example, flexion of the forearm against
resistance is quickly checked when the resistance force is suddenly
broken off . The patient with cerebellar disease can not break the
movement of the limb, and the forearm flies back in a wide arc . This
abnormal response is known as the “ Rebound Phenomenon ”.
Adiadochkinesia ( Dysdiadochkinesia ) : Inability to perform rapidly
alternating opposite movements such as repeated pronation and
supination of the hands .
Difficulty in performing actions that involve simultaneous motions at
more than one joint . The patient dissects such movements and
carries them out one joint at a time , a phenomenon known as “
Decomposition of Movement ” .

July 16, 2024 43

 Flocculonodular Lobe Lesions
Midline cerebellar tumors in children , arising from the “
Nodule ” , early in their course
(& before affecting the rest of the cerebellum) , damage
first the Flocculonodular lobe .
Such a child is afraid ( & reluctant ) to stand erect and
move without support .
This is because if he tries to walk , he does so in a
staggering fashion on a broad base , & tends to fall .
Moreover , selective Flocculonodular lobe lesions may
cause vertigo

July 16, 2024 44

 Role of the Cerebellum in Learning (1)
The cerebellum is concerned with learned
adjustments that make coordination easier when
a given task is performed over & over
As a motor task is learned, activity in the brain
shifts from the Prefrontal (cerebral) Cortex to the
(1) Parietal Cortex, (2) M1 , & (3) Cerebellum .
The basis of learning in the cerebellum is the
input via the Olivary Nucleus.
It is worth noting , in this regard , that each
Purkinje cell receives inputs from 250,000 to
1,000,000 Mossy fibers.
By contrast , each Purkinje cell receives only a
single ( only one ) Climbing fiber from the inferior
olive , and this fiber makes 200-3000 synapses
on the Purkinje cell .
July 16, 2024 45