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Cerebellum

Dr Craig Hacking ◉ ◈ and A.Prof Frank Gaillard ◉ ◈ et al.

The cerebellum, meaning "the little brain", sits at the base of the brain in the posterior cranial fossa below the tentorium and behind the brainstem.

On this page:

Article:

Gross anatomy
CSF cisterns
Blood supply
Variant anatomy
Related articles
References

Images:

Cases and figures

Gross anatomy

The cerebellum has the following features:

three surfaces: anterior (petrosal), superior (tentorial), inferior (suboccipital)
three fissures: primary (tentorial), horizontal (petrosal), prebiventral/prepyramidal (suboccipital)
two hemispheres
single median vermis

Vermis

The vermis is divided into nine lobules: (in a clockwise rotation, looking at the patient sagittally from his left), and separated into groups by fissures:

lingula
central lobule
culmen: primary (tentorial) fissure
declive
folium: horizontal (petrosal) fissure
tuber: prebiventral/prepyramidal (suboccipital) fissure
pyramid
uvula
nodulus

The subdivisions of the cerebellar vermis can be remembered by this mnemonic.

Cerebellar hemisphere

The cerebellar folia run parallel to the calvaria in an onion-like configuration.

Each of the nine vermis lobules is associated in both sides with two cerebellar hemisphere lobules and therefore the cerebellum has 18 cerebellar hemisphere lobules:

wing of lingula (lingula)
wing of central lobule (central lobule)
quadrangular lobule (culmen): primary (tentorial) fissure
simple lobule (declive)
superior semilunar lobule (folium): horizontal (petrosal) fissure
inferior semilunar lobule (tuber): prebiventral/prepyramidal (suboccipital) fissure
biventral lobule (pyramid)
tonsil (uvula)
flocculus (nodulus)

Connections to brainstem

to the midbrain via the superior cerebellar peduncles (brachia conjunctiva)
to the pons via the middle cerebellar peduncles (brachia pontis)
to the medulla via the inferior cerebellar peduncles (restiform bodies)

CSF cisterns

Blood supply

The cerebellum is essentially supplied by three bilateral vessels from the vertebrobasilar system:

superior cerebellar artery (SCA): branch of the distal basilar artery
anterior inferior cerebellar (AICA): branch of the proximal basilar artery
posterior inferior cerebellar (PICA): branch of the distal vertebral arteries

Superior cerebellar (SCA)

The SCA supplies:

whole superior surface of the cerebellar hemispheres down to the great horizontal fissure
the superior vermis
dentate nucleus
most of the cerebellar white matter
superior cerebellar peduncle
middle cerebellar peduncle

Anterior inferior cerebellar (AICA)

The AICA has a variable vascular territory depending on the size of the PICA (see AICA-PICA dominance) but usually supplies:

middle cerebellar peduncle
inferolateral portion of the pons
flocculus
anteroinferior surface of the cerebellum

Posterior inferior cerebellar (PICA)

The PICA has a variable vascular territory depending on the size of the AICA (see AICA-PICA dominance), but usually supplies:

posteroinferior cerebellar hemispheres (up to the great horizontal fissure)
inferior portion of the vermis
inferior cerebellar peduncle

It divides into lateral and medial branches that supply the inferior portion of the vermis and cerebellar hemispheres respectively.

There are some variations in the PICA:

18% arise extracranially, inferior to the foramen magnum
10% arise from the basilar rather than vertebral artery
2% bilaterally absent
occasionally loops around the cerebellar tonsil
occasionally a small vertebral artery will terminate into a common PICA/AICA trunk

Variant anatomy

cerebellar agenesis
tonsillar ectopia: asymptomatic protrusion of the tonsils through the foramen magnum by no more than 3-5 mm

Quiz questions

References

Anatomy: Brain

brain
- grey matter
- white matter
- cerebrum
  - cerebral hemisphere (telencephalon)
  - white matter tracts
  - deep grey matter
    - basal ganglia
      claustrum
  - pituitary gland
    - posterior pituitary and stalk (part of diencephalon)
      - ectopic posterior pituitary
    - anterior pituitary
    - inferior hypophyseal arterial circle
  - diencephalon
    - thalamencephalon
    - subthalamus
      - subthalamic nuclei
    - hypothalamus
- brainstem
  - midbrain (mesencephalon)
  - pons (part of metencephalon)
    - facial colliculus
    - superior olivary nucleus
  - medulla oblongata (myelencephalon)
    - olive
    - inferior olivary nucleus
  - white matter
  - grey matter (non-cranial nerve)
- cerebellum (part of metencephalon)
  - vermis
  - cerebellar hemisphere
    - cerebellar tonsil
    - dentate nucleus
  - cerebellar peduncles
- cranial meninges (meninx primitiva)
- CSF spaces
  - ventricular system
  - subarachnoid cisterns
- cranial nerves (mnemonic)
  - olfactory nerve (CN I)
  - optic nerve (CN II)
    - optic chiasm
    - optic tract
  - oculomotor nerve (CN III)
  - trochlear nerve (CN IV)
  - trigeminal nerve (CN V) (mnemonic)
  - abducens nerve (CN VI)
  - facial nerve (CN VII) (segments mnemonic | branches mnemonic)
    - geniculate ganglion
    - nervus intermedius
  - vestibulocochlear nerve (CN VIII)
  - glossopharyngeal nerve (CN IX)
    - Jacobson nerve
  - vagus nerve (CN X)
    - Arnold's nerve
  - spinal accessory nerve (CN XI)
  - hypoglossal nerve (CN XII)
- functional neuroanatomy
  - Brodmann areas
  - cortical motor system
    - extrapyramidal system
  - cortical sensory system
    - pain and temperature sensation
    - vibration and proprioception sensation
  - auditory/speech system
    - Broca's area (Brodmann area 44)
    - Wernicke's area (Brodmann area 22)
  - visual system
  - olfactory system
- CNS development
  - brain development
- cerebral vascular supply
  - arteries
    - vascular territories
    - circle of Willis
      - internal carotid artery (ICA) (segments)
        
        inferolateral trunk
        
        meningohypophyseal trunk
        inferior hypophyseal artery
        
        capsular arteries (of McConnell) (variable)
        
        superior hypophyseal artery
        
        anterior cerebral artery (ACA)
        
        anterior communicating artery (ACOM)
        
        medial lenticulostriate arteries
        
        recurrent artery of Heubner
        
        medial frontobasal artery
        
        frontopolar artery
        
        orbitofrontal artery
        
        pericallosal artery
        
        callosomarginal artery
        
        pericallosal moustache
        
        middle cerebral artery (MCA)
        
        M1 branches
        
        lenticulostriate arteries
        
        medial lenticulostriate arteries
        
        lateral lenticulostriate arteries
        
        anterior temporal artery
        
        temporopolar artery
        
        M2 branches
        
        posterior communicating artery (PCOM)
        
        ophthalmic artery
        
        lacrimal artery
        
        supraorbital artery
        
        posterior ethmoidal artery
        
        anterior ethmoidal artery
        
        internal palpebral artery
        
        supratrochlear artery (frontal artery)
        
        dorsal nasal artery
        
        anterior choroidal artery
      - vertebral artery
        
        posterior inferior cerebellar artery (PICA)
        
        basilar artery
        
        anterior inferior cerebellar artery (AICA)
        labyrinthine artery
        
        pontine arteries
        
        superior cerebellar artery (SCA)
        
        posterior cerebral artery (PCA)
        
        calcarine artery
        
        splenial artery
        
        posterior choroidal artery
        
        medial posterior choroidal artery
        
        lateral posterior choroidal artery
      - normal variants
        
        intracranial arterial fenestration
        
        internal carotid artery (ICA)
        
        absent ICA
        
        aberrant ICA
        
        anterior cerebral artery (ACA)
        azygos ACA
        
        middle cerebral artery (MCA)
        
        accessory MCA
        
        duplicated MCA
        
        MCA fenestration
        
        posterior cerebral artery (PCA)
        
        fetal origin of PCA / fetal PCOM
        
        artery of Percheron
        
        basilar artery
        
        basilar artery fenestration
        
        basilar artery hypoplasia
        
        persistent carotid-vertebrobasilar artery anastomoses (mnemonic)
        
        persistent primitive trigeminal artery
        
        persistent otic artery
        
        persistent hypoglossal artery
        
        persistent proatlantal artery
        
        persistent proatlantal intersegmental artery
        
        posterior cerebral circulation
  - cerebral venous system
    - dural venous sinuses
    - cerebral veins
      - superficial veins of the brain
        
        superior cerebral veins (superficial cerebral veins)
        
        inferior cerebral veins
        
        superficial middle cerebral vein
        
        superior anastomotic vein (of Trolard)
        
        inferior anastomotic vein (of Labbe)
    - deep veins of the brain
    - normal variants
      - persistent falcine sinus
- glymphatic pathway

Article information

rID: 891

System: Central Nervous System

Tag: neuroanatomy, anatomy rewrite

Synonyms or Alternate Spellings:

Cerebellum anatomy
Anatomy of the cerebellum
Cerebellar anatomy

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Cases and figures

Figure 1: vascular territories Figure 1: vascular territories

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Figure 2: superior cerebellum Figure 2: superior cerebellum

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Figure 3: mid-cerebellumFigure 3: mid-cerebellum

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Figure 4: Inferior cerebellum Figure 4: Inferior cerebellum

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Cerebellum (sagittal) - Gray's anatomy illustrationCerebellum (sagittal) - Gray's anatomy illustration

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