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Cerebellum
Anatomy / Central Nervous System
Last Updated: 11th April 2019
The infratentorial cerebellum consists of two lateral hemispheres and a midline part. It, sits within the posterior cranial fossa and lies between the temporal and occipital lobes and the brainstem.
Cerebellum. (Image by Patrick J. Lynch [CC BY 2.5 , via Wikimedia Commons)
Function
The cerebellum has three primary functions:
- Maintenance of posture and balance
- Maintenance of muscle tone
- Coordination of voluntary motor activity
Therefore postural reflexes, truncal stability and synergistic muscular movements all depend upon an intact cerebellum. Cerebellar lesions do not cause paralysis but do lead to disturbance of balance and movement.
Blood Supply
The cerebellum receives its blood supply from the posterior inferior cerebellar artery, the anterior inferior cerebellar artery and the superior cerebellar artery. Interruption to the blood flow in any of the blood vessels will lead to cerebellar signs.
Clinical Implications
Cerebellar dysfunction is characterised by DANISH signs:
- Dysmetria (past-pointing) and Dysdiadochokinesia (inability to perform rapid alternating movements)
- Ataxia (lack of coordination of gait, trunk and limbs)
- Nystagmus
- Intention tremor
- Slurred/Scanning/Staccato Speech
- Hypotonia
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- Biochemistry
- Blood Gases
- Haematology
| Biochemistry | Normal Value |
|---|---|
| Sodium | 135 – 145 mmol/l |
| Potassium | 3.0 – 4.5 mmol/l |
| Urea | 2.5 – 7.5 mmol/l |
| Glucose | 3.5 – 5.0 mmol/l |
| Creatinine | 35 – 135 μmol/l |
| Alanine Aminotransferase (ALT) | 5 – 35 U/l |
| Gamma-glutamyl Transferase (GGT) | < 65 U/l |
| Alkaline Phosphatase (ALP) | 30 – 135 U/l |
| Aspartate Aminotransferase (AST) | < 40 U/l |
| Total Protein | 60 – 80 g/l |
| Albumin | 35 – 50 g/l |
| Globulin | 2.4 – 3.5 g/dl |
| Amylase | < 70 U/l |
| Total Bilirubin | 3 – 17 μmol/l |
| Calcium | 2.1 – 2.5 mmol/l |
| Chloride | 95 – 105 mmol/l |
| Phosphate | 0.8 – 1.4 mmol/l |
| Haematology | Normal Value |
|---|---|
| Haemoglobin | 11.5 – 16.6 g/dl |
| White Blood Cells | 4.0 – 11.0 x 109/l |
| Platelets | 150 – 450 x 109/l |
| MCV | 80 – 96 fl |
| MCHC | 32 – 36 g/dl |
| Neutrophils | 2.0 – 7.5 x 109/l |
| Lymphocytes | 1.5 – 4.0 x 109/l |
| Monocytes | 0.3 – 1.0 x 109/l |
| Eosinophils | 0.1 – 0.5 x 109/l |
| Basophils | < 0.2 x 109/l |
| Reticulocytes | < 2% |
| Haematocrit | 0.35 – 0.49 |
| Red Cell Distribution Width | 11 – 15% |
| Blood Gases | Normal Value |
|---|---|
| pH | 7.35 – 7.45 |
| pO2 | 11 – 14 kPa |
| pCO2 | 4.5 – 6.0 kPa |
| Base Excess | -2 – +2 mmol/l |
| Bicarbonate | 24 – 30 mmol/l |
| Lactate | < 2 mmol/l |
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