The Physiology and Pathology of the Cerebellum

The Physiology and Pathology of the Cerebellum

Copyright Date: 1958
Edition: NED - New edition
Pages: 692
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  • Book Info
    The Physiology and Pathology of the Cerebellum
    Book Description:

    The development of electrical methods of recording activity in the nervous system has greatly augmented our knowledge of cerebellar physiology. Now, for the first time in a single volume, this new information has been related to facts derived from older methods of investigation. Previously unpublished reports of experiments conducted at the Institute of Physiology, University of Pisa, Italy, also are included. The authors, an American clinical neurologist and an Italian neuro-physiologist, have collaborated to provide a comprehensive review of cerebellar physiology and a survey of the clinical symptomatology of cerebellar disorders and the pathology of the cerebellum._x000B_In Part I, devoted to the physiology, the authors review the literature completely and place it in proper relation to the latest developments in this field. There are chapters on this history of cerebellar physiology, ablation experiments, stimulation experiments, electro-physiological experiments, the relations between the cerebellum and other central nervous structures, developmental physiology, and the functions of the cerebellum, considered generally. Part II is devoted to the human cerebellum as studied in the clinic. Where anatomical and physiological observation may shed light upon obscure clinical findings, the laboratory data are related to the clinical investigations. The disorders and diseases affecting the cerebellum are systemically reviewed. The book is illustrated with 61 halftones and 124 line drawings._x000B_

    eISBN: 978-0-8166-6217-3
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Preface
    (pp. v-viii)
    R. S. D. and G. M.
  3. Table of Contents
    (pp. ix-xvi)
  4. Part I. Physiology
    • 1 Historical Introduction
      (pp. 3-7)

      THE history of cerebellar physiology begins with the seventeenth century, when Du Verny (1673) reported that he had been able to keep pigeons alive whose cerebrum and cerebellum had been extirpated. From Galen to Thomas Willis (1664) no experiments were performed; writers indulged only in theoretical speculations, which were generally based upon gross anatomical observations. Readers interested in the pre-experimental phase of biology should consult the monographs of Neuburger (1897) and the article by Rawson (1932). Only the outlines will be given here.

      Galen thought the hard, firm consistency of the cerebellum suggested that its function was one to impart...

    • 2 Ablation Experiments
      (pp. 8-102)

      The most obvious and, historically, the first approach to a study of the function of an organ is to observe an animal after the organ is removed in whole or in part. Experiments of this type were applied to the cerebellum, as to most other bodily structures, in the preliminary efforts to evaluate its functional significance.

      There have been three principal sources of error throughout the entire history of cerebellar investigation. The first one is the failure to recognize differences between species, with the result that effects seen after cerebellar ablation in subprimate forms were mistakenly expected to be found...

    • 3 Stimulation Experiments
      (pp. 103-157)

      THE discovery by Fritsch and Hitzig (1870) of the “electrical excitability” of the motor cortex prompted several physiologists to investigate whether movements could be elicited also by stimulating the surface of the cerebellum. Underlying these early endeavors, and indeed such recent papers as those of Mussen (1927, 1930, 1931, 1934), was the assumption that cerebellar responses should be similar in type to those obtained from the motor area of the cerebrum and that the different parts of the body were likely to be represented all over the cerebellar cortex more or less in the same way as had been so...

    • 4 Electrophysiological Experiments
      (pp. 158-253)

      ALTHOUGH the beginning of electrophysiological investigations on the cerebellum can be traced back to the pioneer works of Beck and Bikeles (1912a, b) and of Camis (1919), only within the last twenty years have investigations in this field acquired a remarkable momentum.

      Electrophysiological methods have been used more frequently for an anatomical than for a physiological approach. The anatomical task of mapping out the afferent and the efferent connections of the cerebellum was successfully achieved with the technique of evoked potentials through the joint work of several investigators. As will be pointed out later, most of the data gathered by...

    • 5 Relations between the Cerebellum and Other Central Structures
      (pp. 254-358)

      ROSSI (1927) was the first to realize that the motor innervation of the muscle spindles was likely to be of major importance in the proprioceptive regulation of muscle tonus. In a paper devoted to the postural asymmetries elicited by localized cerebellar lesions, he went as far as to make the remarkable prediction that “i centri più elevati non debbano occuparsi, per cosi dire, di inviare impulsi alle cellule motorie che innervano direttamente il muscolo, ma che sia forse sufficiente una loro azione sugli elementi contrattili degli organi di recezione” (p. 148). This statement might still be used to epitomize modern...

    • 6 Developmental Physiology
      (pp. 359-367)

      THE development of the cerebellum has been extensively investigated by the anatomists (see Larsell, 1958), but there are only a few works on the physiological side of the problem. Two main lines of approach have been followed: first, the histogenesis of the cerebellar cortex has been compared with the development of postural and motor functions in the newborn animal; second, ablation, stimulation, and electrophysiological experiments have been performed at different intervals from birth.

      The reader is referred to Ramón y Cajal’s book (1909–1911, vol. 2, pp. 81–106) and to the volume by Larsell (1958) that will be a...

    • 7 General Considerations on the Function of the Cerebellum
      (pp. 368-374)

      AS FAR as we know, all communication between the cerebellum and other neural structures must be carried out by means of all-or-none impulses, coursing along the afferent and efferent fibers of the cerebellar peduncles. An impressive amount of detailed information on the manifold variety of incoming and outgoing signals has been gathered in the last twenty years. This is mainly the result of the stimulation experiments and bioelectric recordings that became possible upon the introduction of electronic instruments.

      Some of these new findings hardly could have been predicted from the results of the ablation experiments performed at the end of...

  5. Part II. Clinical Symptomatology and Pathology
    • 8 The Clinical Symptomatology of Cerebellar Disorders
      (pp. 377-398)

      THE preceding portion of this book has been concerned with the cerebellum of animals as studied through ablation, stimulation, and electrophysiological experiments. This portion is devoted to the cerebellum as studied in the clinic. Some of the most significant facts about this part of the brain have come from clinicians who studied their patients carefully, and these data are of primary importance for an understanding of the function of the cerebellum in man. But anatomical and physiological observations are also of importance in the light that they may shed upon clinical observations that have thus far been obscure.

      While no...

    • 9 The “Cerebellar” Symptomatology of Extracerebellar Lesions
      (pp. 399-407)

      There is no essential difference between the disorders of muscular movement that result from lesions of the cerebellar peduncles and those that result from damage to the cerebellum proper. This also applies to involvement of these tracts within the brain stem. Clinically the differentiation between intracerebellar and extracerebellar lesions is made on the basis of the chronological sequence in the development of the total clinical picture.

      If the lesion is in the brain stem, the early development of signs resulting from the involvement of the corticospinal tracts, the ascending sensory pathways, and the cranial nerves is the feature distinguishing it...

    • 10 Convulsive and Hyperkinetic Disorders of the Cerebellum
      (pp. 408-415)

      Convulsive seizures in association with cerebellar lesions have been rather infrequently referred to in the literature. Fulton in 1929 published a translation of the earliest report on record, written by Wurffbain in 1691. The attack of head retraction and opisthotonos described is very similar to the attacks subsequently described by Stephen Mackenzie and published by Hughlings Jackson in 1906, now commonly called “cerebellar fits” (Fig. 154). Jackson’s report is as follows (p. 429): “Sometimes but not always, the seizure was preceded by a loud cry. There was no twitching of the face nor any special deviation of the eyeballs. His...

    • 11 Developmental Anomalies of the Cerebellum
      (pp. 416-444)

      THIS chapter will be concerned with the abnormalities of the cerebellum resulting from defects in its development as opposed to degenerative changes occurring to portions of the organ which have already formed. To distinguish between the two is not so easy as might at first appear, for atrophy may occur along with anomalous development, and to make the distinction often becomes possible only after careful study of the histological material from many parts of the brain to determine which changes represent agenesis and which secondary atrophy. For purposes of description some classification is necessary, and it is important to attempt...

    • 12 Atrophic Changes of the Cerebellum and Its Connecting Pathways
      (pp. 445-479)

      THE neurological diseases which are associated with atrophic changes in the cerebellum remain one of the most confused chapters in the whole field of clinical neurological literature. This is not surprising in view of the difficulties of clinical differential diagnosis between the various pathological types, the lack of general agreement on the pathology, the confusion of terminology, and finally the almost complete ignorance of the etiology of any of the pathologically recognizable varieties within this group of diseases.

      Even to suggest a logical classification for these diseases is difficult. The variety of classifications proposed is evidence that none of them...

    • 13 Acute Inflammatory and Toxic Disorders of the Cerebellum
      (pp. 480-493)

      MALARIA involves the cerebellum along with the rest of the central nervous system. Brill and Pellicano (1943), in classifying the clinical types of cerebral malaria, list ataxic and cerebellar types along with nine other types. Clinical syndromes of cerebellar type have been described in cases of malaria by Irish (1946), Russo (1947), Danaraj (1949a), and many others. While signs of cerebellar deficiency are completely reversible in many patients, they are not always so. In the case described in detail by Irish (1946) the onset of the malaria occurred in the South Pacific in mid-January. The patient was stuporous on arrival...

    • 14 Chronic Infections of the Cerebellum and Cerebellar Abscess
      (pp. 494-509)

      TUBERCULOSIS of the central nervous system may involve the epidural space, the dura mater, or the leptomeninges, either as a chronic localized variety or as a diffuse tuberculous meningitis. Isolated parenchymatous lesions or tuberculomas are also found, and these may be combined with the leptomeningitis, the symptoms of the meningitis predominating over those resulting from the tuberculoma. Scott and Groves by 1933 had collected 815 cases of tuberculoma of the brain since the first report of this condition, which is credited to Ford in 1790. Asenjo, Valladares, and Fierro (1951) have presented a recent review of the literature and an...

    • 15 Vascular Diseases of the Cerebellum
      (pp. 510-520)

      THE cerebellum is supplied by three arteries, the posterior inferior cerebellar from the vertebral, the anterior inferior cerebellar and the anterior superior cerebellar from the basilar. The first and last contribute to the blood supply of the deep nuclei (Shellshear, 1922; Fazzari, 1933). Except for these deep branches, there are no end arteries but a plexus of anastomotic channels formed between the branches of the three arteries and the corresponding ones of the other side. There is a great deal of variation in these arteries. Stopford (1916–1917) has not only described the arterial anatomy in great detail but has...

    • 16 Cerebellar Trauma
      (pp. 521-525)

      TRAUMA to the cerebellum, like cerebral trauma, may be classified into concussion, contusion, laceration, and traumatic hemorrhage. Cerebellar concussion, if it occurs, is so overshadowed by the effects of concussion on the rest of the nervous system that it has no practical significance and it does not manifest its presence in any clinically observable way. Contusion, while it does occur, does not in itself usually result in any clinically evident manifestations or any sequelae such as the focal convulsive disorders that may result after cerebral contusion. Lecount and Apfelbach (1920) found cerebellar contusion in 30.89 per cent of fatal fractures...

    • 17 Cerebellar Tumors
      (pp. 526-564)

      THE number of monographs dealing with intracranial tumors or some aspect of the subject is in itself testimony to the importance of it. Worthy of particular mention is the study of Bailey and Gushing (1926), which first introduced some order into the pathology of intracranial tumors. Puusepp (1927–1929), Purves-Stewart (1927), Cushing (1932), Dandy (1932), Bailey (1933), McLean (1937), and many others have also dealt with the problems of intracranial neoplasms as a whole. Other monographs published since 1926 specifically concerning the cerebellum have been confined to a discussion of neoplasms of the posterior fossa (Martel and Guillaume, 1934), to...

  6. Bibliographical Index of Authors
    (pp. 567-634)
  7. Subject Index
    (pp. 637-675)