Neurobiology 2025: Cerebellar Anatomy

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Questions and Answers

Which of the following is a primary function of the cerebellum?

  • Initiating voluntary muscle contractions
  • Coordinating movement and balance (correct)
  • Processing olfactory information
  • Regulating hormones

Which of the following is NOT typically considered one of the main anatomical structures of the cerebellum?

  • Vermis
  • Flocculonodular lobe
  • Cerebellar cortex
  • Olfactory bulb (correct)

Which cerebellar nuclei is the most lateral?

  • Fastigial nucleus
  • Dentate nucleus (correct)
  • Interposed nucleus
  • Nodulus

What is the main function of the pontocerebellar module?

<p>Control of voluntary movements (C)</p> Signup and view all the answers

Which of the following best describes dysdiadochokinesia?

<p>Inability to perform rapid, alternating movements (D)</p> Signup and view all the answers

What is the primary function of the spinocerebellar module?

<p>Regulation of muscle tone and posture (C)</p> Signup and view all the answers

A lesion in the vestibulocerebellar module is most likely to result in which of the following?

<p>Truncal ataxia (D)</p> Signup and view all the answers

Which clinical sign is most associated with lesions affecting the vestibulocerebellum?

<p>Truncal ataxia (A)</p> Signup and view all the answers

Paradoxical vestibular signs related to cerebellar lesions may result from damage to which structure?

<p>Caudal cerebellar peduncle (B)</p> Signup and view all the answers

Which of the following is a common cause of cerebellar disorders?

<p>Cerebellar infarction (C)</p> Signup and view all the answers

Which of the following is a known cause of acquired cerebellar disease?

<p>Neospora canis infection (D)</p> Signup and view all the answers

Metronidazole toxicity primarily affects which part of the nervous system?

<p>Cerebellum (A)</p> Signup and view all the answers

Which inherited condition leads to premature degeneration of Purkinje cells?

<p>Cerebellar abiotrophy (D)</p> Signup and view all the answers

Which of the following is a typical characteristic of cerebellar abiotrophy?

<p>Slowly progressive ataxia (B)</p> Signup and view all the answers

Which is a common sign associated with cerebellar abiotrophy?

<p>Intention tremor (A)</p> Signup and view all the answers

Which of the following breeds is predisposed to cerebellar abiotrophy?

<p>Brittany Spaniel (C)</p> Signup and view all the answers

Storage diseases primarily affect the cerebellum due to:

<p>Selective affinity of storage substances for Purkinje cells (D)</p> Signup and view all the answers

Which of the following is a characteristic feature of storage diseases affecting the cerebellum?

<p>Normal development initially followed by neurological decline (B)</p> Signup and view all the answers

Which diagnostic finding is most indicative of a storage disease affecting the cerebellum?

<p>Vacuolated lymphocytes on blood smear (A)</p> Signup and view all the answers

What is the typical prognosis for animals affected by storage diseases?

<p>Progressive deterioration with poor long-term outcome (B)</p> Signup and view all the answers

A dog presents with intention tremors and dysmetria. Lesions in which region of the cerebellum are most likely to be responsible?

<p>Lateral hemispheres (C)</p> Signup and view all the answers

A dog exhibits truncal ataxia and a wide-based stance. Which area of the cerebellum is most likely affected?

<p>Vestibulocerebellum (C)</p> Signup and view all the answers

A Shih Tzu presents with acute inability to walk and stiffness in the front legs. This presentation is most consistent with a disorder affecting which part of the brain?

<p>Cerebellum (D)</p> Signup and view all the answers

Which of the following best describes hypermetria?

<p>Movements that exceed the target (A)</p> Signup and view all the answers

A veterinarian suspects a cerebellar lesion in a canine patient and performs a neurological exam. Which of the following deficits would be most indicative of cerebellar dysfunction?

<p>Uncoordinated gait (A)</p> Signup and view all the answers

Which imaging modality is most useful for evaluating cerebellar structure and identifying abnormalities such as tumors or infarcts?

<p>Magnetic Resonance Imaging (MRI) (C)</p> Signup and view all the answers

What is the role of the fastigial nucleus in relation to the vestibulocerebellum?

<p>It is the primary output nucleus. (C)</p> Signup and view all the answers

Which best describes the function of the olivo-cerebellar pathway?

<p>Integrates motor prediction with sensory feedback. (A)</p> Signup and view all the answers

Which gait abnormality is most commonly observed in patients with cerebellar lesions?

<p>Ataxic gait (C)</p> Signup and view all the answers

What is the primary role of Purkinje cells in the cerebellar cortex?

<p>Inhibitory output to deep cerebellar nuclei (A)</p> Signup and view all the answers

The term 'decomposition of movement' refers to what clinical finding in cerebellar disease?

<p>Inability to coordinate the sequence of motor acts for a given task (C)</p> Signup and view all the answers

A 3-year-old Terrier presents to the clinic with a chronic progressive ataxia, what is the most likely cause?

<p>Cerebellar abiotrophy (C)</p> Signup and view all the answers

What diagnostic test is commonly used to confirm storage diseases?

<p>Enzyme assay (A)</p> Signup and view all the answers

A veterinarian is explaining the function of the cerebellum to a client. Which analogy would be most accurate?

<p>The cerebellum is like a fine-tuning mechanism, adjusting movements. (B)</p> Signup and view all the answers

What are the anatomical components of the cerebellomedullary cistern?

<p>Cerebellum, medulla oblongata, and arachnoid trabeculae (D)</p> Signup and view all the answers

In a case of cerebellar disease, which of the following signs would indicate involvement of the flocculonodular lobe?

<p>Vestibular signs (B)</p> Signup and view all the answers

In storage diseases, which cellular organelle is most directly involved in the disease pathophysiology?

<p>Lysosome (C)</p> Signup and view all the answers

When examining a patient with a suspected cerebellar disorder, which test evaluates the animal's ability to precisely touch its nose?

<p>Nose-touching test (C)</p> Signup and view all the answers

Which of the following is the best way to differentiate a cerebellar disorder from a similar spinal cord disorder?

<p>Check the cranial nerve function (A)</p> Signup and view all the answers

Why do storage diseases particularly affect the cerebellum?

<p>It relies on consistent enzymatic activity (C)</p> Signup and view all the answers

Which of the following is a key characteristic of cerebellar abiotrophy?

<p>Normal development at birth followed by premature degeneration of Purkinje cells. (C)</p> Signup and view all the answers

Which of the following best describes the role of the spinocerebellar module?

<p>Regulation of posture, muscle tone, and axial body control (B)</p> Signup and view all the answers

In cases of cerebellar disorders affecting the vestibulocerebellum, which clinical sign is the LEAST likely to be observed?

<p>Intention tremors (D)</p> Signup and view all the answers

A veterinarian is presented with a 3-year-old Terrier exhibiting progressive ataxia and absence of menace reflex. What is a highly likely differential diagnosis?

<p>Cerebellar abiotrophy. (D)</p> Signup and view all the answers

In a canine patient presenting with paradoxical vestibular signs due to a cerebellar lesion, which neuroanatomical structure is most likely affected, leading to this unusual presentation?

<p>Cerebellopontine angle (A)</p> Signup and view all the answers

Obstruction of the lateral apertures of the fourth ventricle is most likely to result in what condition?

<p>Hydrocephalus (D)</p> Signup and view all the answers

Which anatomical structure is part of the central vestibular system and, when affected, can produce vestibular clinical signs?

<p>Flocculonodular lobe (C)</p> Signup and view all the answers

A lesion in the rostral vermis of the cerebellum is most likely to result in which clinical sign?

<p>Opisthotonus (A)</p> Signup and view all the answers

Which of the following clinical signs is typically associated with lesions affecting the cerebellar hemispheres (lateral zones)?

<p>Intention tremor (A)</p> Signup and view all the answers

Which of the following best describes the function of the pontocerebellar pathway?

<p>Planning of fine movements (A)</p> Signup and view all the answers

What clinical sign is most indicative of paradoxical vestibular disease associated with a cerebellar lesion?

<p>Head tilt away from the side of the lesion (D)</p> Signup and view all the answers

Which vascular event is a common cause of acute cerebellar dysfunction in dogs?

<p>Cerebellar infarction (C)</p> Signup and view all the answers

Which of the following infectious diseases can, in some cases, directly affect the cerebellum?

<p>Canine distemper (D)</p> Signup and view all the answers

Which of the following is a potential consequence of administering excessive doses of metronidazole?

<p>Cerebellar dysfunction (A)</p> Signup and view all the answers

In the context of cerebellar disorders, what is cerebellar abiotrophy?

<p>Premature degeneration of cerebellar cells (B)</p> Signup and view all the answers

Which of the following is a typical clinical sign associated with cerebellar abiotrophy?

<p>Intention tremors (C)</p> Signup and view all the answers

What is the underlying cause of neurological deficits observed in storage diseases affecting the cerebellum?

<p>Accumulation of undigested metabolites (C)</p> Signup and view all the answers

Which clinical sign is commonly observed in animals affected by storage diseases, particularly those involving the cerebellum?

<p>Progressive ataxia (B)</p> Signup and view all the answers

Which of the following neurological deficits would be most indicative of cerebellar dysfunction?

<p>Intention tremors (C)</p> Signup and view all the answers

A dog exhibits a head tilt to the right, positional vestibular strabismus on the right, and is non-ambulatory. What is the most likely localization?

<p>Cerebellar disease (C)</p> Signup and view all the answers

A dog presents with a head tilt to the right and a lesion on the left side of the cerebellum seen on MRI. What condition is most likely?

<p>Paradoxical vestibular disease (A)</p> Signup and view all the answers

A dog presents with severe vestibular ataxia, a head tilt to the left, and increased muscle tone in all four legs. Which area of the brain is most likely affected?

<p>Cerebellum (D)</p> Signup and view all the answers

A cat is diagnosed with alpha-mannosidosis. What cellular change would be expected in the Purkinje cells?

<p>Enlarged cells with foamy cytoplasm (C)</p> Signup and view all the answers

Which of the following features is characteristic of degenerative brain diseases?

<p>Progressive signs over weeks and months (B)</p> Signup and view all the answers

What is the function of the lateral apertures located in the fourth ventricle?

<p>To allow CSF to exit into the subarachnoid space. (A)</p> Signup and view all the answers

What is the most likely diagnosis for a three-year-old dog presenting with prancing, incoordination, bunny hopping, and hypermetria in all four limbs?

<p>Cerebellar abiotrophy (D)</p> Signup and view all the answers

What are the three nuclei of the cerebellum?

<p>Lateral, interposital, fastigous (B)</p> Signup and view all the answers

Which of the following is a potential cause of cerebellar malformation?

<p>Parvo infections (B)</p> Signup and view all the answers

Where are the vestibular nuclei located relative to the brainstem?

<p>Dorsal (top) of the brainstem (C)</p> Signup and view all the answers

If a dog is suspected of having a cerebellar infarction, which area of the cerebellum is most likely affected?

<p>Rostral cerebellum (D)</p> Signup and view all the answers

Which clinical sign is associated with damage to the vermis of the cerebellum?

<p>Changes in muscle tone (B)</p> Signup and view all the answers

What clinical sign is commonly observed in animals with diffuse cerebellar disease when they attempt coordinated movements?

<p>Intention tremors (C)</p> Signup and view all the answers

Which of the following is a key characteristic of degenerative conditions affecting the cerebellum?

<p>They are often breed-associated and inherited (B)</p> Signup and view all the answers

A cat presents with intermittent intention tremors, difficulty walking on slippery floors, and decreased menace response bilaterally. What is the most likely localization of the lesion?

<p>Cerebellum (A)</p> Signup and view all the answers

Which diagnostic method is used to measure enzyme activities in erythrocytes to diagnose lysosomal storage disorders?

<p>Metabolic testing (B)</p> Signup and view all the answers

In cases of suspected cerebellar disease, which of the following clinical signs would be LEAST likely to be observed?

<p>Muscle weakness (D)</p> Signup and view all the answers

A 10-year-old dog presents with ataxia, head tremors, and seizures. MRI reveals a shrunken cerebellum. What is the most likely diagnosis?

<p>Cerebellar abiotrophy (D)</p> Signup and view all the answers

Which component of the cerebellum would you suspect is affected if a patient shows signs of vestibular ataxia, vertical nystagmus and a head tilt?

<p>Flocculonodular lobe. (A)</p> Signup and view all the answers

What is a key difference between degenerative brain diseases and other types of neurological disorders?

<p>Degenerative diseases are often breed-associated and inherited (C)</p> Signup and view all the answers

If you have damage to the lateral hemispheres of the cerebellum, but NOT an affect on the vermis nor flocculonodular lobe, what clinical signs might you observe?

<p>Normal vestibular signs, but hypermetria. (A)</p> Signup and view all the answers

In a patient with a pontocerebellar lesion. What is the connection that is interrupted that causes them to not be able to perform precise movements?

<p>Connection of the hemispheres to the Cortex. (A)</p> Signup and view all the answers

Why do storage diseases affect the cerebellum more than any other location in the brain?

<p>Sugar metabolites accumulate at a rapid rate. (A)</p> Signup and view all the answers

Why might a veterinarian opt to move a dog around, versus watching it stand, to recognize Opisthotonus?

<p>The dog may be able to compensate, but not when moved. (B)</p> Signup and view all the answers

What is a potential negative effect from performing a brain biopsy?

<p>Areas might be missed, so it's only representative of a small area.. (A)</p> Signup and view all the answers

Which of the following best describes the role of lysosomes in the cell, relevant to storage disorders?

<p>Waste and trash removal (D)</p> Signup and view all the answers

Which statement accurately describes the typical onset and progression of clinical signs in animals with storage disorders?

<p>Normal at birth, with slow progression of signs over time. (D)</p> Signup and view all the answers

If an animal is non-ambulatory, and suffering from right-sided strabismus and a head tilt, how can a veterinarian confirm the localization of the lesion to the cerebellum?

<p>Rule out spinal cord lesions, then perform MRI. (A)</p> Signup and view all the answers

The cerebellum is anatomically located:

<p>Dorsal to the brainstem. (A)</p> Signup and view all the answers

Which anatomical structure is formed by the space between the brainstem and the cerebellum?

<p>Fourth ventricle (C)</p> Signup and view all the answers

The cerebellar vermis is located:

<p>Between the cerebellar hemispheres. (D)</p> Signup and view all the answers

Which cerebellar structures are considered part of the central vestibular system?

<p>Flocculus and nodulus (A)</p> Signup and view all the answers

Obstruction of the lateral apertures of the fourth ventricle would most directly lead to:

<p>Hydrocephalus (C)</p> Signup and view all the answers

Which cerebellar nucleus primarily receives input from the vermis?

<p>Fastigial nucleus (B)</p> Signup and view all the answers

The pontocerebellar module is primarily associated with the function of the:

<p>Lateral hemispheres (C)</p> Signup and view all the answers

A lesion in the rostral vermis of the cerebellum is most likely to result in:

<p>Opisthotonus (A)</p> Signup and view all the answers

Hypermetria, characterized by exaggerated movements, is primarily associated with dysfunction of the:

<p>Pontocerebellar module (B)</p> Signup and view all the answers

Paradoxical vestibular disease in cerebellar lesions refers to:

<p>Head tilt opposite to the side of the lesion. (B)</p> Signup and view all the answers

Cerebellar infarctions in dogs most commonly occur in the:

<p>Rostral cerebellum (B)</p> Signup and view all the answers

Metronidazole toxicity primarily affects the cerebellum due to its impact on:

<p>Purkinje cell metabolism (A)</p> Signup and view all the answers

Cerebellar abiotrophy is characterized by premature degeneration primarily of which cell type?

<p>Purkinje cells (B)</p> Signup and view all the answers

In storage diseases affecting the cerebellum, the primary cellular organelle involved in the pathophysiology is the:

<p>Lysosome (D)</p> Signup and view all the answers

Which clinical sign is LEAST likely to be associated with a lesion predominantly affecting the flocculonodular lobe?

<p>Intention tremors (D)</p> Signup and view all the answers

In cerebellar disease, opisthotonus is most indicative of a lesion in the:

<p>Rostral vermis (C)</p> Signup and view all the answers

The term 'intention tremor' in cerebellar disease refers to tremors that:

<p>Worsen during purposeful movement. (A)</p> Signup and view all the answers

Medial strabismus (deviation of the eye inwards) can be associated with a deficit of which cranial nerve?

<p>Cranial nerve VI (Abducens) (A)</p> Signup and view all the answers

In a dog with a cerebellar lesion causing paradoxical vestibular signs and a right head tilt, the lesion is most likely located in the:

<p>Left cerebellar hemisphere (C)</p> Signup and view all the answers

Which of the following clinical signs is most suggestive of diffuse cerebellar disease rather than a focal lesion?

<p>Intention tremors and ataxia (C)</p> Signup and view all the answers

In a young animal presenting with progressive cerebellar signs, which diagnostic category should be considered high on the differential list?

<p>Degenerative disorders (C)</p> Signup and view all the answers

Which diagnostic test is most useful for visualizing structural changes in the cerebellum, such as infarction or atrophy?

<p>Magnetic Resonance Imaging (MRI) (C)</p> Signup and view all the answers

In cases of suspected storage diseases, enzyme activity assays are typically performed on:

<p>Erythrocytes (D)</p> Signup and view all the answers

Compared to peripheral vestibular disease, central vestibular disease due to cerebellar lesions is MORE likely to present with:

<p>Vertical nystagmus (A)</p> Signup and view all the answers

The hierarchical structure of the cerebellum, from gray matter leaflets to white matter and nuclei, reflects its organization for:

<p>Complex motor coordination and learning. (B)</p> Signup and view all the answers

Which of the following is a key differentiating factor between degenerative brain diseases and acute conditions like cerebellar infarction?

<p>Sudden versus gradual onset of clinical signs (A)</p> Signup and view all the answers

In the context of storage diseases, the accumulation of undigested metabolites within cells leads to cellular dysfunction primarily by:

<p>Disrupting normal cellular metabolism and organelle function. (C)</p> Signup and view all the answers

The presence of increased muscle tone in all four limbs, alongside vestibular ataxia and head tilt, in a canine patient is most suggestive of involvement of the cerebellar:

<p>Flocculonodular lobe and vermis (A)</p> Signup and view all the answers

Which of the following best describes the typical progression of clinical signs in cerebellar abiotrophy?

<p>Slowly progressive with onset in young animals. (C)</p> Signup and view all the answers

The function of the lateral apertures of the fourth ventricle is most crucial for:

<p>Allowing cerebrospinal fluid to exit the ventricular system. (B)</p> Signup and view all the answers

A 3-year-old Terrier presenting with chronic, progressive ataxia and a shrunken cerebellum on MRI is most likely suffering from:

<p>Cerebellar abiotrophy. (B)</p> Signup and view all the answers

In a patient with a pontocerebellar lesion, the interrupted connection that leads to impaired precise movements is primarily between the cerebellum and the:

<p>Cerebral cortex via the pons. (A)</p> Signup and view all the answers

Why does the cerebellum appear to be particularly vulnerable in storage diseases compared to other brain regions?

<p>Predilection of storage substances for Purkinje cells. (C)</p> Signup and view all the answers

To best differentiate between cerebellar disease and a spinal cord disorder causing ataxia, a veterinarian should primarily assess:

<p>Presence of intention tremors and hypermetria. (C)</p> Signup and view all the answers

A dog exhibits truncal ataxia, a wide-based stance, and postural instability. Which area of the cerebellum is most likely affected?

<p>Vermis (A)</p> Signup and view all the answers

Which of the following clinical signs is LEAST likely to be observed in a patient with cerebellar disease?

<p>Paresis (D)</p> Signup and view all the answers

In a cat with alpha-mannosidosis, the foamy cytoplasm observed in Purkinje cells during autopsy is due to the accumulation of:

<p>Mannose-rich oligosaccharides (B)</p> Signup and view all the answers

If a dog is suspected of having a cerebellar infarction, which vascular territory is most likely to be affected?

<p>Rostral cerebellar artery branches (C)</p> Signup and view all the answers

In a neurological exam for cerebellar function, evaluating the animal's ability to precisely touch its nose assesses primarily the:

<p>Pontocerebellar function. (D)</p> Signup and view all the answers

The vestibular nuclei, crucial for balance and vestibular reflexes, are located:

<p>Dorsal aspect of the brainstem. (B)</p> Signup and view all the answers

In advanced degenerative conditions affecting the brain, cerebellar signs are often observed first because:

<p>The cerebellum may be less able to compensate for neuronal loss. (A)</p> Signup and view all the answers

What is the anatomical relationship between the cerebellum and the brainstem?

<p>The cerebellum sits dorsally and on top of the brainstem, forming the fourth ventricle. (C)</p> Signup and view all the answers

Which of the following statements about the lateral apertures of the fourth ventricle is most accurate?

<p>They are critical exit points for CSF from the brain into the subarachnoid space. (A)</p> Signup and view all the answers

A lesion in the vermis of the cerebellum is most likely to result in which specific clinical sign?

<p>Opisthotonus (C)</p> Signup and view all the answers

Why might clinical signs of cerebellar disease be observed even when degenerative conditions primarily affect broader regions of the brain?

<p>The cerebellum is often the first area to show signs due to its sensitivity and the interconnected nature of brain functions. (C)</p> Signup and view all the answers

Flashcards

Cerebellar cortex divisions?

Flocculonodular lobe, Vermis and intermediate zone, Lateral zone.

Cerebellar nuclei?

Fastigial nucleus, Interposed nucleus, and Dentate nucleus.

Connections to brainstem and forebrain?

Caudal cerebellar peduncle, Middle cerebellar peduncle, Rostral cerebellar peduncle.

Function of Pontocerebellar?

Control of voluntary movements.

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Pontocerebellar movements?

Planning and control of precise movements of extremities and distal limbs.

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Pontocerebellar movement timing?

Timing and initiation of movements in distal limbs.

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Pontocerebellar Ataxia/Dysmetria?

Ataxia or dysmetria (unequal length of steps).

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Pontocerebellar Tremors?

Intention tremor, kinetic tremors.

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Decomposition of movement?

Decomposition of movements, only individual components possible.

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Dysdiadochokinesia?

Dysdiadochokinesia (not able to do rhythmic movements).

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Spinocerebellar function?

Influence on muscle tone via reticulospinal, vestibulospinal and corticospinal tracts.

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Spinocerebellar muscle control?

Control of axial and leg muscle function.

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Spinocerebellar posture?

Control of head, trunk and leg posture.

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Spinocerebellar deficits?

Ataxia, hypermetria, abnormal body posture.

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Function of vestibulocerebellum?

Posture, balance and equilibrium of head, axial and proximal limbs muscles, and eyes.

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Vestibulocerebellar ataxia?

Truncal ataxia.

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Vestibulocerebellar stance?

Wide based stance to maintain balance.

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Vestibulocerebellar nystagmus?

Nystagmus most often vertical.

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Cerebellar disorders?

Cerebellar infarction, Neospora canis, distemper, GME, Steroid responsive tremor syndrome, Cerebellar head trauma, Hypo- or aplasia.

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Paradoxical head tilt?

Head tilt to the opposite side of the lesion.

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Lesion location?

Caudal cerebellar peduncle.

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Pathophysiology of lesion?

Loss of direct inhibitory modulation from vermis, flocculonodular lobe.

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Sensory input from peripheral receptors?

Sensory input from peripheral receptors of about 100 Hz is assessed to be higher due to loss of inhibition.

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Vestibular input due to lower.

Head tilt to opposite side because peripheral vestibular input is assessed to be lower.

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V Cerebellar disorders?

Cerebellar infarction.

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I Cerebellar disorders?

Neospora canis, distemper, GME.

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T Cerebellar disorders?

Cerebellar head trauma.

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M Cerebellar disorders?

Metronidazole intoxication.

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D Cerebellar disorders?

Abiotrophy, storage disorders.

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Additional tests?

Mild and chronic kidney disease, Increased urinary, Negative 4Dx, AUS:Liver, TEG: normal limits.

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Rare disorders?

Breed associated and inherited disorders, Rare, Onset, Juvenile.

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Signs and results?

Onset of clinical signs within the first (second) year, Slowly progressive, Most often diffuse cerebellar signs, Autosomal recessive.

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Disorder at birth?

Normal at birth.

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Cells equals apoptosis?

Premature degeneration of mainly Purkinje cells = apoptosis.

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All Cells is normal at birth?

Storage disease, Lack a specific enzyme in the lysosomes, Accumulation non-degradable molecules, All cells affected; cerebellum most vulnerable, Animals normal at birth.

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Difficulty Menace

Alert, Intermittent intention tremors, Difficulty walking, Decreased menace reflex.

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Normal Reflexes?

Normal spinal reflexes, Exaggerated movements, Opisthotonic posture.

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Persistant Signs?

Normal chemistry profile, in CBC persistent leukocytosis and lymphocytosis,FeLV and FIV test negative,Signs of cardiomyopathy.

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Most common disorder?

Cerebellar infarction

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Storage disease in dogs?

Sphingomyelin lipidosis.

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Spinocerebellar sign?

Opisthotonus with rostral lobe

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Spinocerebellar?

Head and body turn.

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A Cerebellar disorder?

Hypo- or aplasia, porencaphaly, Dandy Walker

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Vestibulocerebellar sign?

Truncal ataxia

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Cerebellum location

Located in the back of the brain, sitting on top of the brainstem, forming the fourth ventricle.

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Medullary System

The fluid-filled system tapped for spinal fluid analysis. It's located near the cerebellum.

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Cerebellar Structure

A structure resembling a tree, composed of white matter (trunk) and gray matter (leaflets).

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Nodulus and Flocculus

Located on the ventral part of the cerebellum; important for vestibular function (balance and eye movements).

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Hydrocephalus

Result from obstruction of lateral apertures, preventing CSF from draining into the subarachnoid space.

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Opisthotonus

Dorsal posture of the head due to a lesion in the rostral vermis of the cerebellum.

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Intention Tremor

Fine tremors that occur when a patient attempts a purposeful movement.

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Metronidazole Intoxication

A condition resulting from excessive or prolonged metronidazole use, affecting the brain and often causing cerebellar signs.

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Cerebellar Infarction Case Study

Shih Tzu, 16 years old, cannot walk, high level of stiffness in the front legs, Head tilt to the right side

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Chief's Cerebellar Atrophy

An Australian Terrier came in with ataxia and head tremors.

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Storage Disorders - Brain

Enzyme deficiency in lysosomes leads to buildup, impacting brain cells first.

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Lysosomes

The 'trash service' of the cell; lacking an enzyme leads to accumulation of toxic products and cell damage.

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Degenerative Brain Diseases

Genetic, breed-associated brain disorders with young onset that cause accumulation of toxins or cell loss.

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Cerebellar Abiotrophy

A degenerative condition causing premature loss of Purkinje cells, leading to diffuse cerebellar signs.

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Study Notes

  • This lecture is complex, focusing on an overview of the cerebellum to explain clinical signs.
  • The goal is to understand how much physiology is needed to explain clinical observations.

Basic Anatomy

  • The cerebellum sits on top of the brainstem, forming the fourth ventricle.
  • The medullary system is filled with fluids, allowing for spinal fluid taps.
  • The cerebellum has a structure like a tree, with gray matter leaflets and white matter trunk.
  • The dorsal view shows hemispheres, rostral, and caudal vermis; the ventral view shows nodulus, flocculus, and cerebellar peduncles.
  • The nodulus and flocculus are part of the central vestibular system, affecting vestibular function.
  • The cerebellum includes the vermis, intermediate zone, and large hemispheres.
  • Transverse view: leaflets of gray matter, white matter, lateral, interposital, and fastigous nuclei and the fourth ventricle with choroid plexus.
  • Lateral apertures are important for CSF exit into the subarachnoid space.
  • Obstruction of the lateral apertures leads to hydrocephalus.
  • Vestibular nuclei are located on top of the brainstem.
  • Cerebellar peduncles: medial, rostral, caudal (middle), and lateral.

Functional Relevance

  • The hierarchical organization consists of the vermis, intermediate zone, and lateral zone.
  • Vermis reports to the fascicle nucleus, intermediate zone to the interposed nucleus, and lateral zone to the dentate nucleus.
  • The flocculus and nodulus are close to the vestibular nuclei.

Clinical Modules

  • Damage to specific areas results in varied clinical signs.
  • Flocculonodular lobe issues cause vestibular signs like head tilt and nystagmus.
  • The vermis controls head and leg posture; lesions in the rostral vermis cause opisthotonus.
  • Hemispheres lesions cause pontocerebellar signs: intention tremor and ataxia.

Clinical Signs Pontocerebellar

  • Interruption of the pontocerebellar loop results in hypermetria, tremors, and ataxia.

Clinical Signs Spinocerebellar

  • Damage to the vermis leads to opisthotonos.

Paradoxical Vestibular Disease

  • Head tilt on the opposite side of the lesion is paradoxical.
  • Physiology is unclear.
  • Left-sided damage can cause a right-sided head tilt.

Cerebellar Disorders

  • Cerebellar infarctions are the most common type of infarction.
  • Neospora canis is rare infection.
  • GME is multifocal, affecting more than just the cerebellum.
  • Metronidazole intoxication can cause cerebellar signs.
  • Tumors can occur in the cerebellum.
  • Degenerative conditions and abiotrophy can affect the entire brain, with cerebellar signs appearing first.

Vascular Cerebellar Disorders

Case 1

  • Shih Tzu unable to walk and stiff in front legs.
  • Displayed a head tilt to the right, a slight head turn to the left, and an inability to maintain head control.
  • Exhibited an opisthotonic position, good hopping on the right front leg but not the left, preserved conscious proprioception, and vestibular strabismus.
  • Central vestibular system deficits were suspected.
  • Cerebellar infarction was considered most likely.
  • MRI confirmed an infarction in the rostral part of the cerebellum, extending into the vermis on the left side.

Case 2

  • Pembroke Welsh Corgi presented with sudden thrashing, inability to walk, and rolling.
  • Exhibited severe vestibular ataxia, medial strabismus in the left eye (cranial nerve VI deficit), and increased muscle tone in all limbs.
  • Central vestibular involvement was suspected.
  • MRI showed hyperintensity in the nodulus, indicating flocculonodular lobe involvement.
  • The dog rolled to the left which again demonstrates paradoxical vestibular disease.

Degenerative Disorders

  • Degenerative disorders are breed-associated, inherited, and rare, with juvenile onset.
  • Associated with accumulation of toxic products or premature cell loss.
  • Diagnosis is difficult.

Cerebellar Abiotrophy

  • Affected animals are normal at birth, then experience premature cell loss.
  • Purkinje cells are most affected.
  • Onset is often at a young age, with slow progression.
  • Clinical signs: intention tremors, ataxia, hypermetria, and abnormal menace response.
  • Breeds affected are Australian Kelpie, Brittany Spaniel, and Gordon Setter.

Case 3

  • A Terrier presented with ataxia and hind end weakness.
  • Examination revealed hypermetria and ataxia in both front and hind legs in MRI.
  • MRI showed a small, shrunken cerebellum (height nearly equal to brainstem height), and changes resembled abiotrophy.

Case 4

  • Australian Terrier with ataxia and head tremors.
  • Progressively worsened over the years, leading to walking difficulties and severe tremors.
  • Intention tremors (tremors worsen with intention) were pronounced.

Storage Disease

  • Storage disorders involve a deficiency in lysosomal enzymes.
  • Deficiency results in accumulation of non-degradable molecules.
  • Affected animals are normal at birth.
  • Deficits are progressive and without treatment.
  • Cerebellar disease is most common.

Neurological Exam

  • Intermittent intention tremors and difficulty on slippery floors were noted.
  • Tests revealed decreased menace reflex bilaterally and reduced physiological nystagmus.
  • Abnormal proprioception was present in all four legs.
  • Exaggerated movements occurred when eating and drinking.
  • Opisthotonic posture was seen when holding the cat vertically.

Diagnostics

  • Chemistry profile showed persistent leukocytosis and lymphocytosis.
  • FeLV and FIV tests were negative.
  • Cardiomyopathy signs were observed.
  • Alpha-mannosidosis activity in leukocytes was significantly low.

Summary of Cerebellar Notes

  • Intention tremor is a clear sign of diffuse cerebellum disease.
  • Complex anatomical structure of the cerebellum.
  • Storage changes were found in other parts of the brain, liver, and kidneys.
  • Lesions in specific areas produces different clinical patterns, depending on the part, its function, muscle tone, position of head trunk and legs.
  • Disorders of the cerebellum includes: Cerebellar infarction, tumors, and degenerative conditions.

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