Anatomy of the Cerebellum

The cerebellum is derived from the posterior pars of the

metencephalon (the embryonic part of the hindbrain that
differentiates into the pons and the cerebellum).
Location: its situated in the cerebellar fossa, under the line
binding the zygomatic arch to the external occipital protuberance
and it lies behind the pons and medulla oblongata and beneath the
occipital lobes of the cerebral cortex.
Between the cerebellum and the cerebral trunk we can find the
cavity of the fourth ventricle.
The cerebellum is connected to the cerebrum (by the superior
peduncle), pons (by the middle peduncle) and medulla oblongata
(by the inferior peduncles).
Shape: somewhat oval in form, but constricted medially and
flattened from above downward.
Diameter: its greatest diameter being the transversal one,
measuring 8-10 cm, meanwhile the anterio-posterior diameter is
approximately 5 cm, equal with its vertical diameter.
Weight: about 150 gr.
The grey substance is disposed on the exterior of the cerebellum
where it constitutes the cerebellar cortex, and on the inside,
forming the nuclei.
The white substance forms:

Interiorly: the arbor vitae(tree of life)

exteriorly: the cerebellar peduncles.
The cerebellum may be phylogenetically divided into:
1. the arhicerebellum (the lingula and the flocculonodular
lobe)- is mainly concerned in mantaining equilibrium.
2. the paleocerebellum which is mainly concerned with
maintaining synergism of the different parts of the body, and
in the synergism of their associated automatic movements.
3. the neocerebellum, which coordinates the skilled
movements of the body.

Morphogenesis
The cerebellum is derived from the posterior pars of the
metencephalus between days 40-45.
The cerebellum increases its volume 6x, from the 18mm length
embryo, to the 30mm length.
RELATIONS OF THE CEREBELLUM
On each side of the medial line, the cerebellum is in relation with:

the bone structure that encloses the posterior cranial fossa

(the posterior petrosal portion of the temporal bone, the
occipitomastoid suture and the jugular foramina)
the vasculonervous elements from this level
the sigmoid sinuses,
the inferior petrosal sinus,
the internal jugular vein
the VII and the VII intermediary Wrisbergs nerves
the VIII cranial nerve at the internal acoustic meatus level
the IX, X and the XI-th cranial nerve at the jugular foramina.
The anterior part of the cerebellum is in relation with:

the posterior recess of the fourth ventricle, (that is margined

by: the superior and inferior medullary velum, the nodulus,
the uvula and also by the cerebellar peduncles of the same
side.)
The cerebellar circumference is in relation with:
the Vieussens valvulae frenum and the inferior quadrigeminal
colliculus, in the anterior part.
the falx cerebelli, which is located in the posterior (The falx cerebelli
is a sagittal median septum, located between cerebellar
hemispheres, at small distance from the inferior side of the vermis.
The cerebellar circumference is crossed by the great circumferential
sulcus of Vicq d'Azyr.

EXTERNAL CONFIGURATION
The cerebellum has an ovoid shape, with three different parts: the
vermis, and the two cerebellar hemispheres.
The anterior face of the cerebellum looks forward and downwards,
three pairs of cerebellar peduncles emerging from this level.
The fourth ventricle is delimited by the cerebellar peduncles and other
elements (the Vieussens valve, the nodulus, the uvula and the superior
face of Tarins valvulae).

The anterior face of the cerebellum is also called the cerebellum

nervous hilum, because at this level are located the cerebellar
peduncles trough which the cerebellum realizes its connections.
The superior surface of the cerebellum has a convex shape,
presenting on its medial line the superior pars of the vermis.
On each side of the medial line, there is a plane surface lining
outwards and downwards, which corresponds to the superior face of
the hemispheres.
The superior face, presents at the level of the vermis:
-the lingula,
-the lobulus centralis,
-the monticulus
-the folium vermis, adding the corresponding lobules on the
cerebellar hemispheres.
The inferior face has a convex aspect, especially at the level of the
cerebellar hemispheres.
The inferior vermis, sends two lateral prolongations, which
disappear in the cerebellar hemispheres.
The inferior surface presents at the level of the vermis:
-the tuber
-the pyramis
-the uvula
-the nodulus, adding the correspondent lobules on the
cerebellar hemispheres.
The cerebellar circumference has the aspect of a bold, rounded
margin, which separates the superior face of the cerebellum, from
the inferior one.
On the anterior part, the cerebellar circumference a semilunar
notch, named incisura cerebelli anterior, which corresponds to the
frenulum of the Vieussens valve, and to the quadrigeminal inferior
colicullas.
On the posterior part, the cerebellar circumference presents a
posterior notch, in relation with the falx cerebelli.
As mentioned before, the falx cerebelli is crossed by the
circumferential Vicq dAzis sulcus, the Vieussenss vlave and the
inferior quadrigeminal colicullus.!!!!!!
Development of Fissures
First degree sulci: these sulci are delimitating the lobes, and
reach until the level of the white matter.
Second degree sulci: these sulci are delimitating the lobules and
dont reach the level of the white substance.
Third degree sulci: these are delimitating the laminas or folia.

Development of lobes
The cerebellum is formed from functional and phylogeneticaly
distinct parts.
In sagittal plane, the cerebellum was divided by Edinger, in 1911
into:
-one median lobe, named the vermis
-two lateral lobes, called the
cerebellar hemispheres
-one posterior lobe, formed by the
nodulus and the floculus

INTERNAL STRUCTURES
On a section, the cerebellum has three parts, represented by
-the peripheral gray substance (the cerebellar cortex),
-the white substance and
-the central gray substance.
The gray substance is located both in the periphery, where it forms
the cerebellar cortex, and central, where it constitutes the cerebellar
nuclei.
The cerebellar cortex (cortex cerebellaris)
is constituted by three layers:
-the molecular layer (stratum moleculare), superficially located
-the Purkinje cells layer (stratum piriformium)- intermediary
located
-the granular layer (stratum granulosum)- profoundly
located(nonmyelinated axons)
The cerebellar nuclei are located in the anterior pars of the
cerebellum, in the middle mass of the white substance.
The cerebellum has four pairs nuclei.4 Enumerated from to
inwards, they are:
 -the nucleus dentatus (seratus)
-the nucleus emboliformis
-the nucleus globulosus
-the nucleus fastigii
The white substance in formed by myelinic nervous fibers,
occupying the central pars of the cerebellum.
The central pars of the cerebellum forms the medullary centre
whose division in white laminas, forms on section, the arbore vitae.
At the level of the hilum, the white substance is continued by the
cerebellar peduncles.
At the level of the roof of the fourth ventricle, the medullary center
form two white substance laminas, which will constitute the velum
medullare superius, (Vieussens valve) and the velum medullare
inferius (Tarins valve).

CEREBELLUM CONNECTIONS
Altough the archi, paleo and neocerebellum are not distinctly
separated from each other, the organisation of the connections
reported to the archi, paleo and the neocerebellum, is maintained
considering the predominant connection with:
- the vestibular nuclei for the arhicerebellum
- the spinal cord for the paleocerebellum
- the cerebral cortex, trough the brainstem for the neocerebellum
1.The arhicerebellum afferences pathways are represented by:
-the vestibulo-cerebellar fascicles
-the tectospinal tract (colliculospinal tract)
-the tecto-ponto-cerebellar tract
1.The arhicerebellum efferences are realised by:
-the direct cerebellum-vestibular fascicles
-the crossed cerebellum-vestibular fascicles
2.The afferent tracts of the paleocerebellum are represented by:
-the dorsal spino-cerebellar tract (Flechsigs direct tract)
originated in the Clarkes collumn (dorsal nucleus, posterior thoracic
nucleus) from the inferior thoracic and lumbar spinal cord.
 -the ventral spino-cerebellar tract (Gowerss crossed tract),
originated in the Bechterews nucleus
2.The efferent fascicles that descend from
-the nucleus gracilis (Goll)
-the nucleus cuneatus (Burdach),
-the nucleus cuneatus lateralis ( Von Monakov),
trough the inferior cerebellar peduncle, ending in the uvula, the
pyramis, the culmen, the central lobe, the lingula
The paleocortex also receives efferences from:
-the olivo-cerebellar tract
-the reticulo-cerebellar tract (the bulbar pontine formatio
reticularis, receiving afferences from the motor cerebral cortex,
realises trough the reticulo-cerebellar fascicles, an optimising action
over the tonic functions of the cerebellum.
-the tectocerebellar tract (which arrives to the cerebellum trough
the superior cerebellar peduncles, associating the functions of
equilibrium and muscular tonus modulation, with the visual and
acoustic reflex centres)
The paleocortex efferences are realized by:
-the cerebello-rubral tract, which passes trough the superior
cerebellar peduncle, crosses the medial line at the level of
Werneckinks decussation, and arrives to the magnocellular red
nucleus.
The rubrospinal fascicles emerge from the nucleus rubrum, and after
crossing over again the medial line, arrives to the spinal cord.
-the cerebello-olivary tract, which passes trough the inferior
cerebellar peduncle to the oliva in the opposite side of the medulla
oblongata.
-the cerebello-reticular tract. Some of the fascicles are passing
trough the middle cerebellar peduncle, ending at the opposite side
of formatio reticularis of the pons, and others pass trough the
inferior cerebellar peduncle, to the medial pars of the medulla
oblongata formatio reticularis.
3.The afferences of the neocerebellum are realised by:
-the cortico-pontine-cerebellar fascicles, which are originated in the
temporal and frontal cerebral cortex or in the parieto-occipital
cortex.
 -the olivo-cerebellar tract, which emerges from the oliva, passes
trough the inferior cerebellar peduncle, arriving to the hemispheric
cortex on the opposite side.
-The reticulo-neocerebellar tract
-The rubro-cerebellar fascicles
-The arciform fascicles
3.The efferences of the neocerebellum are realised by:
-the dento-rubric fascicle, which emerges from the dentate
nucleus, passes trough the superior cerebellar peduncle, arrives to
the nucleus rubrum after crossing at the level of Werneckiks
decussation.
-the dento-thalamic fascicle which follows the superior cerebellar
peduncle trajectory without crossing anywhere, and arrives to the
lateralis and centromedian nuclei of the thalamus.

The arteries of the cerebellum

The cerebellum is supplied by six main arteries, disposed in three
pairs. These are:
-the superior right and left cerebellar arteries
-the right and left posterior inferior cerebellar arteries
-the right and left anterior inferior cerebellar arteries
1. The superior cerebellar artery (artera superior cerebelli), is the
biggest.
It is originated on the lateral side of the basilar trunk, being at close-
quarters of its ending.
It has a slight winding trajectory, parallel to the pedunculo-pontine
sulcus.
It surrounds the lateral side of the cerebral peduncles, to approach
the upper side of the cerebellum.
It branches out into a veritable fan of terminal branches grouped
into:
-a medial group, represented by the superior vermian arteries,
intended for the superior vermis.
-a lateral group, represented by an artery which approaches the
correspondent hemispheric circumference
-an intermediary group, located between the precedent ones
 -The perforans branches, emerged from the superior cerebellar
artery, are supplying the cerebellar nuclei, and
-other branches contribute in forming the choroid plexus of the
fourth ventricle.
2. The posterior inferior cerebellar artery (artera posterior inferior
cerebelli) originates from the vertebral artery.
Its trajectory is headed anteriorly along the medulla oblongata, and
then it inflects upwards to the inferior side of the cerebellum, where
it will supply the inferior vermis and the infero-lateral side of the
cerebellar hemispheres.
The medial branches of this artery, are supplying parts of the
choroid plexus of the fourth ventricle.
3. The anterior inferior cerebellar artery (artera inferior cerebelli), is
the biggest inferior branch of the basilar trunk.
It heads sideways and supplies the inferior side of the cerebellum,
namely to the pyramis, tuber, floculus and parts of the inferior side
of the cerebellar hemispheres.
The perforans branches will supply the nucleus dentatus, and other
branches will contribute in forming the choroid plexus of the fourth
ventricle.

The veins of the cerebellum

The veins of the cerebellum divide into anterior and lateral vermian
veins.
The vermiam veins are symmetrically disposed in rapport with the
medial line. There are described an antero-superior (vena superior
vermis) and a postero-inferior (vena inferior vermis) vermian veins.
1.The anterior veins are draining the venous blood of the anterior
versant and of the hilum cerebelli.
2.the lateral veins are draining the venous blood of the cerebellar
hemispheres. It contains:
a.the superior veins (venae superiores cerebelli)
b.the inferior veins (venae inferiores cerebelli).
The superior and inferior veins, are subdivided into an anterior
group, a lateral group and a medial group.

THE CEREBELLAR PEDUNCLES

The cerebellar peduncles are six columns of white substance which
connects the brainstem to the cerebellum.
They are disposed in three symmetrical pairs which unite the
cerebellum with the three levels of the brain stem.
The cerebellar peduncles are constituted from afferent or efferent
white matter fibers which are connecting the cerebellar cortex or
the cerebellar nuclei with:
the spinal grey substance,
bulbar nuclei,
pontine nuclei
mesencephalic nuclei.
The cerebellary superior peduncles (pedunculus cerebellaris
superior) and the inferior cerebellary peduncles (pedunculus
cerebellaris inferior), are framing the fourth ventricle.
The cerebellar hilum is located between the cerebellary peduncles.
THE SUPERIOR CEREBELLAR PEDUNCLES
Relations:
1.The superior right and left cerebellar peduncles are connecting the
cerebellum with the mesencephalon.
They extend from the cerebellum to the dorsal side of the cerebellar
peduncles.
On their trajectory they are approaching closer to the medial line to
finally disappear on the dorsal side of the mesencephalon, under the
posterior quadrigeminal colliculus
Connections:
The afferences are represented by:
the reticulo-cerebellar fascicle from the mesencephalon
the Gowers fascicle, which surrounds the superior cerebellar
peduncles, without exactly passing trough them.
The efferences are represented by:

the dento-rubric fascicle

dento-thalamic fascicle
cerebellar-vestibular fascicle
Most of the superior cerebellar peduncles fibers are crossed in the
tegmentum at the level of the inferior quadrigeminal colliculus,
behind and under the nucleus rubrum, forming the Werneckinks
decussation.
In the superior cerebellar peduncles injuries, symptoms like
:asynergia, dysmetria, hypotony, and an-intentional tremor, only
when the dentorubric pathways are involved.
THE MIDDLE CEREBELLAR PEDUNCLES
Relations:
The middle cerebellar peduncles (pedunculus cereballaris medius),
are connecting the cerebellum with the pons. They are located at
the level of an oblique plane passing at one centimeter outside the
trigeminal nerve.
The superior side corresponds to the ponto-cerebellar angle.
They are the largest and get bigger on approaching to the pons. The
middle cerebellar peduncles have four sides: anterior, posterior,
superior and inferior.
Connections:
The afferences are represented by:
the pontine-cerebellar fascicles
the tecto-pontine-cerebellar fascicles
The efferences are represented by:
the cerebellar reticulate fascicles
THE INFERIOR CEREBELLAR PEDUNCLES
Relations:
The inferior cerebellar peduncles are connecting the cerebellum
with the medulla oblongata.
At their origin, are located between the superior cerebellar
peduncles, located inwards, and the medial cerebellar peduncles,
located outwards.
The anterior side is in relations with the medulla oblongata.
The external side is in relations with the cerebellar tonsils.
Connections:
The afferences are represented by:

Flechsigs fascicle
Olivary-cerebellar fascicle
Vestibulary-cerebellar fascicle
Reticulocerebellar fascicle
The efferences are represented by:
 the cerebellar-olivary fascicle
In the middle cerebellar peduncles injuries, involving the pons, the
patient will present: asynergia, hypermetria (overreaching the
intended goal, by exaggerating the movement), dysmetria,
lateropulsion.
In the inferior cerebellar peduncles injuries will appear:,
hypermetria(dysmetria) asynergia and hypotonia at the level of the
limbs on the same side with the lesion, usually without having an
intentional tremor.

THE CEREBELLAR NUCLEI

-the nucleus dentatus
-the nucleus emboliformis
-the nucleus globulosus
-the nucleus fastigii