Cerebellar tonsil

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Cerebellar tonsil
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Anterior view of the cerebellum. (Tonsil visible at center right.)
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Sagittal section of the cerebellum, near the junction of the vermis with the hemisphere. (Tonsil visible at bottom center.)
Details
Part of Cerebellum
Artery PICA
Identifiers
Latin tonsilla cerebelli
NeuroNames 671
NeuroLex ID nlx_anat_20081212
TA98 A14.1.07.222
TA2 5817
FMA 83464
Anatomical terms of neuroanatomy

The cerebellar tonsil (Latin: tonsilla cerebelli) is a rounded lobule on the undersurface of each cerebellar hemisphere, continuous medially with the uvula of the cerebellar vermis and superiorly by the flocculonodular lobe. Synonyms include: tonsilla cerebelli, amygdala cerebelli, the latter of which is not to be confused with the cerebral tonsils or amygdala nuclei located deep within the medial temporal lobes of the cerebral cortex.

Contents

The flocculonodular lobe of the cerebellum, which can also be confused for the cerebellar tonsils, is one of three lobes that make up the overall composition of the cerebellum. The cerebellum consists of three anatomical and functional lobes: anterior lobe, posterior lobe, and flocculonodular lobe.

The cerebellar tonsil is part of the posterior lobe, also known as the neocerebellum, which is responsible for coordinating the voluntary movement of the distal parts of limbs. [1]

Elongation of the cerebellar tonsils can, due to pressure, lead to this portion of the cerebellum to slip or be pushed through the foramen magnum of the skull resulting in tonsillar herniation. This is a life-threatening condition as it causes increased pressure on the medulla oblongata which contains respiratory and cardiac control centres. A congenital condition of tonsillar herniation of either one or both tonsils is Chiari malformation.

Pathology

A Type I Chiari malformation is a congenital anomaly of the brain in which the cerebellar tonsils are elongated and pushed down through the opening of the base of the skull (see foramen magnum), blocking the flow of cerebrospinal fluid (CSF) as it exits through the medial and lateral apertures of the fourth ventricle. Also called cerebellar tonsillar ectopia, or tonsillar herniation. Although often congenital, Chiari malformation symptoms can also be induced due to physical head trauma, commonly from raised intracranial pressure secondary to a hematoma, or increased dural strain pulling the brain caudally into the foramen magnum. Head trauma increases risk of cerebellar tonsillar ectopia by a factor of 4. Ectopia may be present but asymptomatic until whiplash causes it to become symptomatic. [2]

Additional images

Related Research Articles

An ectopia is a displacement or malposition of an organ or other body part, which is then referred to as ectopic.

<span class="mw-page-title-main">Cerebellum</span> Structure at the rear of the vertebrate brain, beneath the cerebrum

The cerebellum is a major feature of the hindbrain of all vertebrates. Although usually smaller than the cerebrum, in some animals such as the mormyrid fishes it may be as large as it or even larger. In humans, the cerebellum plays an important role in motor control. It may also be involved in some cognitive functions such as attention and language as well as emotional control such as regulating fear and pleasure responses, but its movement-related functions are the most solidly established. The human cerebellum does not initiate movement, but contributes to coordination, precision, and accurate timing: it receives input from sensory systems of the spinal cord and from other parts of the brain, and integrates these inputs to fine-tune motor activity. Cerebellar damage produces disorders in fine movement, equilibrium, posture, and motor learning in humans.

<span class="mw-page-title-main">Chiari malformation</span> Medical condition

Chiari malformation (CM) is a structural defect in the cerebellum, characterized by a downward displacement of one or both cerebellar tonsils through the foramen magnum. CMs can cause headaches, difficulty swallowing, vomiting, dizziness, neck pain, unsteady gait, poor hand coordination, numbness and tingling of the hands and feet, and speech problems. Less often, people may experience ringing or buzzing in the ears, weakness, slow heart rhythm, or fast heart rhythm, curvature of the spine (scoliosis) related to spinal cord impairment, abnormal breathing, such as central sleep apnea, characterized by periods of breathing cessation during sleep, and, in severe cases, paralysis.

Articles related to anatomy include:

<span class="mw-page-title-main">Brainstem</span> Posterior part of the brain, adjoining and structurally continuous

The brainstem is the stalk-like part of the brain that interconnects the cerebrum and diencephalon with the spinal cord. In the human brain, the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is continuous with the thalamus of the diencephalon through the tentorial notch.

<span class="mw-page-title-main">Foramen magnum</span> Opening in the occipital bone of the skull

The foramen magnum is a large, oval-shaped opening in the occipital bone of the skull. It is one of the several oval or circular openings (foramina) in the base of the skull. The spinal cord, an extension of the medulla oblongata, passes through the foramen magnum as it exits the cranial cavity. Apart from the transmission of the medulla oblongata and its membranes, the foramen magnum transmits the vertebral arteries, the anterior and posterior spinal arteries, the tectorial membranes and alar ligaments. It also transmits the accessory nerve into the skull.

<span class="mw-page-title-main">Occipital bone</span> Skull bone, lower back of cranium

The occipital bone is a cranial dermal bone and the main bone of the occiput. It is trapezoidal in shape and curved on itself like a shallow dish. The occipital bone overlies the occipital lobes of the cerebrum. At the base of the skull in the occipital bone, there is a large oval opening called the foramen magnum, which allows the passage of the spinal cord.

<span class="mw-page-title-main">Dura mater</span> Outermost layer of the protective tissues around the central nervous system (meninges)

In neuroanatomy, dura mater is a thick membrane made of dense irregular connective tissue that surrounds the brain and spinal cord. It is the outermost of the three layers of membrane called the meninges that protect the central nervous system. The other two meningeal layers are the arachnoid mater and the pia mater. It envelops the arachnoid mater, which is responsible for keeping in the cerebrospinal fluid. It is derived primarily from the neural crest cell population, with postnatal contributions of the paraxial mesoderm.

<span class="mw-page-title-main">Fourth ventricle</span> Ventricle in front of the cerebellum

The fourth ventricle is one of the four connected fluid-filled cavities within the human brain. These cavities, known collectively as the ventricular system, consist of the left and right lateral ventricles, the third ventricle, and the fourth ventricle. The fourth ventricle extends from the cerebral aqueduct to the obex, and is filled with cerebrospinal fluid (CSF).

<span class="mw-page-title-main">Cerebellar vermis</span> Structure connecting the two cerebellar hemispheres

The cerebellar vermis is located in the medial, cortico-nuclear zone of the cerebellum, which is in the posterior fossa of the cranium. The primary fissure in the vermis curves ventrolaterally to the superior surface of the cerebellum, dividing it into anterior and posterior lobes. Functionally, the vermis is associated with bodily posture and locomotion. The vermis is included within the spinocerebellum and receives somatic sensory input from the head and proximal body parts via ascending spinal pathways.

<span class="mw-page-title-main">Posterior cranial fossa</span> Area of the cranium containing the brainstem and cerebellum

The posterior cranial fossa is the part of the cranial cavity located between the foramen magnum, and tentorium cerebelli. It is formed by the sphenoid bones, temporal bones, and occipital bone. It lodges the cerebellum, and parts of the brainstem.

<span class="mw-page-title-main">Falx cerebri</span> Anatomical structure of the brain

The falx cerebri is a large, crescent-shaped fold of dura mater that descends vertically into the longitudinal fissure between the cerebral hemispheres of the human brain, separating the two hemispheres and supporting dural sinuses that provide venous and CSF drainage to the brain. It is attached to the crista galli anteriorly, and blends with the tentorium cerebelli posteriorly.

<span class="mw-page-title-main">Cerebellar tentorium</span> Vertebrate brain structure separating the cerebellum from the occipital lobes

The cerebellar tentorium or tentorium cerebelli is an extension of the dura mater between the inferior aspect of the occipital lobes and the superior aspect of the cerebellum. The free border of the tentorium gives passage to the midbrain.

<span class="mw-page-title-main">Brain herniation</span> Potentially deadly side effect of very high pressure within the skull

Brain herniation is a potentially deadly side effect of very high pressure within the skull that occurs when a part of the brain is squeezed across structures within the skull. The brain can shift across such structures as the falx cerebri, the tentorium cerebelli, and even through the foramen magnum. Herniation can be caused by a number of factors that cause a mass effect and increase intracranial pressure (ICP): these include traumatic brain injury, intracranial hemorrhage, or brain tumor.

<span class="mw-page-title-main">Dandy–Walker malformation</span> Congenital malformation of the cerebellar vermis

Dandy–Walker malformation (DWM), also known as Dandy–Walker syndrome (DWS), is a rare congenital brain malformation in which the part joining the two hemispheres of the cerebellum does not fully form, and the fourth ventricle and space behind the cerebellum are enlarged with cerebrospinal fluid. Most of those affected develop hydrocephalus within the first year of life, which can present as increasing head size, vomiting, excessive sleepiness, irritability, downward deviation of the eyes and seizures. Other, less common symptoms are generally associated with comorbid genetic conditions and can include congenital heart defects, eye abnormalities, intellectual disability, congenital tumours, other brain defects such as agenesis of the corpus callosum, skeletal abnormalities, an occipital encephalocele or underdeveloped genitalia or kidneys. It is sometimes discovered in adolescents or adults due to mental health problems.

<span class="mw-page-title-main">Posterior inferior cerebellar artery</span>

The posterior inferior cerebellar artery (PICA) is the largest branch of the vertebral artery. It is one of the three main arteries that supply blood to the cerebellum, a part of the brain. Blockage of the posterior inferior cerebellar artery can result in a type of stroke called lateral medullary syndrome.

<span class="mw-page-title-main">Falx cerebelli</span> Skull anatomy

The falx cerebelli is a small sickle-shaped fold of dura mater projecting forwards into the posterior cerebellar notch as well as projecting into the vallecula of the cerebellum between the two cerebellar hemispheres.

<span class="mw-page-title-main">Head and neck anatomy</span>

This article describes the anatomy of the head and neck of the human body, including the brain, bones, muscles, blood vessels, nerves, glands, nose, mouth, teeth, tongue, and throat.

<span class="mw-page-title-main">Cranial fossa</span>

A cranial fossa is formed by the floor of the cranial cavity.

References

PD-icon.svgThis article incorporates text in the public domain from page 791 of the 20th edition of Gray's Anatomy (1918)

  1. Mavridis, I (2014). "Gross and neurosurgical anatomy of the cerebellar tonsil". S2CID   16241375.{{cite web}}: Missing or empty |url= (help)
  2. Freeman, MD (2010). "A case-control study of cerebellar tonsillar ectopia (Chiari) and head/neck trauma (whiplash)". Brain Injury. 24 (7–8): 988–94. doi:10.3109/02699052.2010.490512. PMID   20545453. S2CID   9553904.