Subscribe to RSS

DOI: 10.1055/s-0045-1814379
A journey through the anatomy of the cerebellum
Authors
Abstract
The present narrative review delves into the multifaceted roles of the cerebellum, highlighting its significance beyond traditional motor functions to encompass cognitive and behavior-related processes, as evidenced by advancements in functional neuroimaging. We provide a comprehensive summary of the cerebellum's embryological development, intricate microanatomy, macroanatomy, and vascular anatomy of the cerebellum, revealing how these aspects contribute to its unique circuitry and operational capabilities. A non-systematic literature search was conducted using the PubMed database, focusing on landmark and recent studies addressing the embryology, anatomy, clinical correlations and radiological aspects of the cerebellum. Ultimately, this review underscores the cerebellum's complex structure and diverse function, advocating for a deeper understanding to improve diagnostic and therapeutic approaches for cerebellar disorders.
Authors' Contributions
Conceptualization: JVGT, RPCH, FMRF, OGPB, JLP; Data curation: JVGT, RPCH, FMRF, OGPB, JLP; Formal analysis: JVGT, RPCH, FMRF, OGPB, JLP; Funding acquisition: JVGT, RPCH, FMRF, OGPB, JLP; Investigation: JVGT, RPCH, FMRF, OGPB, JLP; Methodology: JVGT, RPCH, FMRF, OGPB, JLP; Project administration: JVGT, RPCH, FMRF, OGPB, JLP; Resources: JVGT, RPCH, FMRF, OGPB, JLP; Software: JVGT, RPCH, FMRF, OGPB, JLP; Supervision: JVGT, RPCH, FMRF, OGPB, JLP; Validation: JVGT, RPCH, FMRF, OGPB, JLP; Visualization: JVGT, RPCH, FMRF, OGPB, JLP;Writing – original draft: JVGT, RPCH, LGBS, LFMB, FR, LAC, VRP, FCN, FMRF, OGPB, JLP;Writing – review & editing: JVGT, RPCH, LGBS, VRP, FCN, FMRF, OGPB, JLP. These authors contributed equally to this article: JVG, RPCH.
Data Availability Statement
Data will be available upon request to the corresponding author.
Editor-in-Chief: Hélio A. G. Teive. (https://orcid.org/0000-0003-2305-1073).
Associate Editor: Mariana Spitz. (https://orcid.org/0000-0001-7548-2313).
Publication History
Received: 15 May 2025
Accepted: 03 October 2025
Article published online:
22 December 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil
João Vitor Gerdulli Tamanini, Raphael Pinheiro Camurugy da Hora, Luís Gustavo Biondi Soares, Luiz Fernando Monte Borella, Fabiano Reis, Luis Ángel Canache, Victor Rebelo Procaci, Feres Chaddad-Neto, Flávio Moura de Rezende Filho, Orlando Graziani Povoas Barsottini, José Luiz Pedroso. A journey through the anatomy of the cerebellum. Arq Neuropsiquiatr 2025; 83: s00451814379.
DOI: 10.1055/s-0045-1814379
-
References
- 1 Singh R, Singh R. Cerebellum: Its Anatomy, Functions and Diseases. In: Tunalı NE. editor. Neurodegenerative Diseases - Molecular Mechanisms and Current Therapeutic Approaches. London: IntechOpen; 2020. ; Available from: https://www.intechopen.com/chapters/72599
- 2 Stoodley CJ. The Cerebellum and Neurodevelopmental Disorders. Cerebellum 2016; 15 (01) 34-37
- 3 Houk JC, Miller LE. Cerebellum: Movement Regulation and Cognitive Functions. In: Encyclopedia of Life Sciences. Hoboken, NJ: John Wiley & Sons, Ltd; 2003.
- 4 Hibi M, Shimizu T. Development of the cerebellum and cerebellar neural circuits. Dev Neurobiol 2012; 72 (03) 282-301
- 5 Jernigan TL, Stiles J. Construction of the human forebrain. Wiley Interdiscip Rev Cogn Sci 2017; 8 (1-2):10.1002/wcs.1409
- 6 Hashimoto M, Hibi M. Development and evolution of cerebellar neural circuits. Dev Growth Differ 2012; 54 (03) 373-389
- 7 Martinez S, Andreu A, Mecklenburg N, Echevarria D. Cellular and molecular basis of cerebellar development. Front Neuroanat 2013; 7: 18
- 8 Wu SR, Butts JC, Caudill MS. et al. Atoh1 drives the heterogeneity of the pontine nuclei neurons and promotes their differentiation. Sci Adv 2023; 9 (26) eadg1671
- 9 Huang X, Liu J, Ketova T. et al. Transventricular delivery of Sonic hedgehog is essential to cerebellar ventricular zone development. Proc Natl Acad Sci U S A 2010; 107 (18) 8422-8427
- 10 Hoshino M, Nakamura S, Mori K. et al. Ptf1a, a bHLH transcriptional gene, defines GABAergic neuronal fates in cerebellum. Neuron 2005; 47 (02) 201-213
- 11 Leto K, Arancillo M, Becker EBE. et al. Consensus Paper: Cerebellar Development. Cerebellum 2016; 15 (06) 789-828
- 12 Chizhikov VV. Roof plate in cerebellar neurogenesis. In: Manto M, Schmahmann JD, Rossi F, Gruol DL, Koibuchi N. editors. Handbook of the Cerebellum and Cerebellar Disorders. Dordrecht: Springer; 2013: 61-74
- 13 Santoro M, Coi A, Barišić I. et al. Epidemiology of Dandy-Walker Malformation in Europe: A EUROCAT Population-Based Registry Study. Neuroepidemiology 2019; 53 (3-4): 169-179
- 14 Parisi MA, Dobyns WB. Human malformations of the midbrain and hindbrain: review and proposed classification scheme. Mol Genet Metab 2003; 80 (1-2): 36-53
- 15 Ocampo-Navia MI, Perez-Mendez W, Rodriguez-Alvarez MP, Chadid-Contreras J, Vergara MF. Dandy-Walker syndrome: an updated literature review. Childs Nerv Syst 2025; 41 (01) 194
- 16 Osenbach RK, Menezes AH. Diagnosis and management of the Dandy-Walker malformation: 30 years of experience. Pediatr Neurosurg 1992; 18 (04) 179-189
- 17 Sun Y, Wang T, Zhang N, Zhang P, Li Y. Clinical features and genetic analysis of Dandy-Walker syndrome. BMC Pregnancy Childbirth 2023; 23 (01) 40
- 18 Grinberg I, Northrup H, Ardinger H, Prasad C, Dobyns WB, Millen KJ. Heterozygous deletion of the linked genes ZIC1 and ZIC4 is involved in Dandy-Walker malformation. Nat Genet 2004; 36 (10) 1053-1055
- 19 Aldinger KA, Lehmann OJ, Hudgins L. et al. FOXC1 is required for normal cerebellar development and is a major contributor to chromosome 6p25.3 Dandy-Walker malformation. Nat Genet 2009; 41 (09) 1037-1042
- 20 Limperopoulos C, Folkerth R, Barnewolt CE, Connolly S, Du Plessis AJ. Posthemorrhagic cerebellar disruption mimicking Dandy-Walker malformation: fetal imaging and neuropathology findings. Semin Pediatr Neurol 2010; 17 (01) 75-81
- 21 Haldipur P, Gillies GS, Janson OK. et al. Foxc1 dependent mesenchymal signalling drives embryonic cerebellar growth. eLife 2014; 3 •••
- 22 Parisi MA, Doherty D, Chance PF, Glass IA. Joubert syndrome (and related disorders) (OMIM 213300). Eur J Hum Genet 2007; 15 (05) 511-521
- 23 Maria BL, Quisling RG, Rosainz LC. et al. Molar tooth sign in Joubert syndrome: clinical, radiologic, and pathologic significance. J Child Neurol 1999; 14 (06) 368-376
- 24 Brancati F, Dallapiccola B, Valente EM. Joubert Syndrome and related disorders. Orphanet J Rare Dis 2010; 5 (01) 20
- 25 Dong Y, Zhang K, Yao H. et al. Clinical and genetic characteristics of 36 children with Joubert syndrome. Front Pediatr 2023; 11: 1102639
- 26 Romani M, Micalizzi A, Valente EM. Joubert syndrome: congenital cerebellar ataxia with the molar tooth. Lancet Neurol 2013; 12 (09) 894-905
- 27 Aguilar A, Meunier A, Strehl L. et al. Analysis of human samples reveals impaired SHH-dependent cerebellar development in Joubert syndrome/Meckel syndrome. Proc Natl Acad Sci U S A 2012; 109 (42) 16951-16956
- 28 Spassky N, Han YG, Aguilar A. et al. Primary cilia are required for cerebellar development and Shh-dependent expansion of progenitor pool. Dev Biol 2008; 317 (01) 246-259
- 29 Köster RW, Fraser SE. Direct imaging of in vivo neuronal migration in the developing cerebellum. Curr Biol 2001; 11 (23) 1858-1863
- 30 Wingate RJT, Hatten ME. The role of the rhombic lip in avian cerebellum development. Development 1999; 126 (20) 4395-4404
- 31 Wassmer E, Davies P, Whitehouse WP, Green SH. Clinical spectrum associated with cerebellar hypoplasia. Pediatr Neurol 2003; 28 (05) 347-351
- 32 Timmann D, Dimitrova A, Hein-Kropp C, Wilhelm H, Dörfler A. Cerebellar agenesis: clinical, neuropsychological and MR findings. Neurocase 2003; 9 (05) 402-413
- 33 Bouanani Z, Rhalem I, Lahnine G. et al. Total cerebellar agenesis: A case report of a very rare condition. Radiol Case Rep 2024; 19 (10) 4569-4571
- 34 Sellick GS, Barker KT, Stolte-Dijkstra I. et al. Mutations in PTF1A cause pancreatic and cerebellar agenesis. Nat Genet 2004; 36 (12) 1301-1305
- 35 Roostaei T, Nazeri A, Sahraian MA, Minagar A. The human cerebellum: a review of physiologic neuroanatomy. Neurol Clin 2014; 32 (04) 859-869
- 36 Van Essen DC, Donahue CJ, Glasser MF. Development and Evolution of Cerebral and Cerebellar Cortex. Brain Behav Evol 2018; 91 (03) 158-169
- 37 Consalez GG, Goldowitz D, Casoni F, Hawkes R. Origins, Development, and Compartmentation of the Granule Cells of the Cerebellum. Front Neural Circuits 2021; 14: 611841
- 38 Purves D, Augustine GJ, Fitzpatrick D. et al. Organization of the Cerebellum. In: ______, editors. Neuroscience. 2nd edition.. Sunderland, MA: Sinauer Associates; 2001. . Available from: https://www.ncbi.nlm.nih.gov/books/NBK11132/
- 39 Splittgerber R. Snell's Clinical Neuroanatomy. 8th edition.. Philadelphia: LWW; 2018
- 40 Perrini P, Tiezzi G, Castagna M, Vannozzi R. Three-dimensional microsurgical anatomy of cerebellar peduncles. Neurosurg Rev 2013; 36 (02) 215-224 , discussion 224–225
- 41 Schmahmann JD, Doyon J, McDonald D. et al. Three-dimensional MRI atlas of the human cerebellum in proportional stereotaxic space. Neuroimage 1999; 10 (3 Pt 1): 233-260
- 42 Lehman VT, Black DF, DeLone DR. et al. Current concepts of cross-sectional and functional anatomy of the cerebellum: a pictorial review and atlas. Br J Radiol 2020; 93 (1106) 20190467
- 43 Ahumada-Vizcaino JC, Wuo-Silva R, Hernández MM, Chaddad-Neto F. The art of combining neuroanatomy and microsurgical skills in modern neurosurgery. Front Neurol 2023; 13: 1076778
- 44 Tamanini JVG, Ribeiro GAS, Kimura AT, Borella LF, Freddi TA, Reis F. Hyperintense lesions of the middle cerebellar peduncle and beyond: a pictorial essay. Radiol Bras 2025; 57: e20240001
- 45 Dekeyzer S, Vanden Bossche S, De Cocker L. Anything but Little: a Pictorial Review on Anatomy and Pathology of the Cerebellum. Clin Neuroradiol 2023; 33 (04) 907-929
- 46 Grimaldi G, Manto M. Topography of cerebellar deficits in humans. Cerebellum 2012; 11 (02) 336-351
- 47 Prati JM, Pontes-Silva A, Gianlorenço ACL. The cerebellum and its connections to other brain structures involved in motor and non-motor functions: A comprehensive review. Behav Brain Res 2024; 465: 114933
- 48 Boillat Y, Bazin PL, Van der Zwaag W. Whole-body somatotopic maps in the cerebellum revealed with 7T fMRI. Neuroimage 2020; 211: 116624
- 49 Batson MA, Petridou N, Klomp DWJ, Frens MA, Neggers SFW. Single session imaging of cerebellum at 7 Tesla: obtaining structure and function of multiple motor subsystems in individual subjects. PLoS One 2015; 10 (08) e0134933
- 50 Schlerf JE, Verstynen TD, Ivry RB, Spencer RMC. Evidence of a novel somatopic map in the human neocerebellum during complex actions. J Neurophysiol 2010; 103 (06) 3330-3336
- 51 Timmann D, Konczak J, Ilg W. et al. Current advances in lesion-symptom mapping of the human cerebellum. Neuroscience 2009; 162 (03) 836-851
- 52 Riecker A, Mathiak K, Wildgruber D. et al. fMRI reveals two distinct cerebral networks subserving speech motor control. Neurology 2005; 64 (04) 700-706
- 53 Leiner HC, Leiner AL, Dow RS. Does the cerebellum contribute to mental skills?. Behav Neurosci 1986; 100 (04) 443-454
- 54 Strick PL, Dum RP, Fiez JA. Cerebellum and nonmotor function. Annu Rev Neurosci 2009; 32: 413-434
- 55 Richter S, Gerwig M, Aslan B. et al. Cognitive functions in patients with MR-defined chronic focal cerebellar lesions. J Neurol 2007; 254 (09) 1193-1203
- 56 Karaci R, Oztürk S, Özbakir S, Cansaran N. Evaluation of language functions in acute cerebellar vascular diseases. J Stroke Cerebrovasc Dis 2008; 17 (05) 251-256
- 57 Riva D, Giorgi C. The cerebellum contributes to higher functions during development: evidence from a series of children surgically treated for posterior fossa tumours. Brain 2000; 123 (Pt 5): 1051-1061
- 58 Levisohn L, Cronin-Golomb A, Schmahmann JD. Neuropsychological consequences of cerebellar tumour resection in children: cerebellar cognitive affective syndrome in a paediatric population. Brain 2000; 123 (Pt 5): 1041-1050
- 59 Delion M, Dinomais M, Mercier P. Arteries and Veins of the Cerebellum. Cerebellum 2017; 16 (5-6): 880-912
- 60 Barth A, Bogousslavsky J, Regli F. The clinical and topographic spectrum of cerebellar infarcts: a clinical-magnetic resonance imaging correlation study. Ann Neurol 1993; 33 (05) 451-456
- 61 Terao S, Sobue G, Izumi M, Miura N, Takeda A, Mitsuma T. Infarction of superior cerebellar artery presenting as cerebellar symptoms. Stroke 1996; 27 (09) 1679-1681
- 62 Kumral E, Kisabay A, Ataç C. Lesion patterns and etiology of ischemia in superior cerebellar artery territory infarcts. Cerebrovasc Dis 2005; 19 (05) 283-290
- 63 Ogawa K, Suzuki Y, Takahashi K, Akimoto T, Kamei S, Soma M. Clinical Study of Seven Patients with Infarction in Territories of the Anterior Inferior Cerebellar Artery. J Stroke Cerebrovasc Dis 2017; 26 (03) 574-581
- 64 Roquer J, Lorenzo JL, Pou A. The anterior inferior cerebellar artery infarcts: a clinical-magnetic resonance imaging study. Acta Neurol Scand 1998; 97 (04) 225-230
- 65 Hartkamp NS, De Cocker LJ, Helle M. et al. In vivo visualization of the PICA perfusion territory with super-selective pseudo-continuous arterial spin labeling MRI. Neuroimage 2013; 83: 58-65
- 66 Miao HL, Zhang DY, Wang T, Jiao XT, Jiao LQ. Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature. Int J Med Sci 2020; 17 (18) 3005-3019
- 67 Ota T. Functional Cerebral Venous Anatomy: A Perspective on Venous Collaterals Part II, Infratentorial Venous System. Stroke Vasc Intervent Neurol 2024; 4 (02) e001060
- 68 De Miquel MA. Posterior Fossa Venous Drainage. Front Neurol 2021; 12: 680515
- 69 Harrigan MR, Deveikis JP. Handbook of Cerebrovascular Disease and Neurointerventional Technique. 4th edition.. Totowa, NJ: Humana Press; 2023.
- 70 Rapalino O. Radiographic Features of Cerebellar Disease: Imaging Approach to Differential Diagnosis. In: Manto MU, Gruol DL, Schmahmann JD, Koibuchi N, Sillitoe RV. editors. Handbook of the Cerebellum and Cerebellar Disorders. 2nd edition.. Cham, Switzerland: Springer; 2022: V.3:721-37
- 71 Currie S, Hadjivassiliou M, Craven IJ, Wilkinson ID, Griffiths PD, Hoggard N. Magnetic resonance imaging biomarkers in patients with progressive ataxia: current status and future direction. Cerebellum 2013; 12 (02) 245-266
- 72 Stoodley CJ, Schmahmann JD. Functional topography in the human cerebellum: a meta-analysis of neuroimaging studies. Neuroimage 2009; 44 (02) 489-501
- 73 Timmann D, Daum I. Cerebellar contributions to cognitive functions: a progress report after two decades of research. Cerebellum 2007; 6 (03) 159-162
- 74 Schmahmann JD, Sherman JC. The cerebellar cognitive affective syndrome. Brain 1998; 121 (Pt 4): 561-579
