All right, folks, we’re going a little deeper today in the brain. Literally. The cerebellum is a small structure that sits at the back of the brain beneath the two hemispheres of the cerebrum. It may be small, but it’s really important.

Air traffic controller station set against a blue sky.

The Cerebellum

Are you ready for another quick Latin lesson?

  • Cerebellum = “Little Brain.”
  • Leonardo da Vinci named it in 1504 while making wax castings of the brain.

I read somewhere that the cerebellum is like an air traffic controller. Air traffic controllers help guide a pilot’s movements for an optimal landing. The cerebellum guides the body to produce the desired outcome. It takes in feedback from the motor and sensory pathways and adjusts the body’s response.

Although the cerebellum takes up only 10% of total brain space, it accounts for almost half of all of the neurons in our brain.

It’s responsible for

  • Posture
  • Balance
  • Coordination
  • Muscle memory and motor learning

Cerebellar strokes are pretty rare. They’re roughly half ischemic and half hemorrhagic.

The most common symptoms include dizziness, difficulty sitting upright, trouble walking, trouble controlling body movements (ataxia), nausea, vomiting, and slurred/slow speech (dysarthria).

Effects of Cerebellar Strokes

We know that some of these symptoms are expected. But we also know that people and their brains are more complicated than a textbook can predict. So stroke survivors may present with different symptoms.

Below, I break down more specific symptoms based on the area of the cerebellum affected. Remember, these are textbook symptoms, so they may not describe everyone’s experience.

Posterior Inferior Cerebellar Artery, or PICA

This artery serves the back, lower part of the cerebellum. It’s the most common site of cerebellar strokes and can lead to

  • Headache
  • Nausea
  • Vomiting
  • Vertigo
  • Nystagmus (rapid involuntary movement of the eyes)
  • Ataxia

Anterior Inferior Cerebellar Artery, or AICA

This artery serves the lower, front area of the cerebellum. This type of stroke can lead to

  • Dysmetria (overreaching/underreaching for items)
  • Horner’s Syndrome (drooping eyelid, decreased pupil size, and decreased sweating on one side of the face)
  • One-sided hearing loss
  • One-sided facial paralysis or sensory loss
  • One-sided bodily pain and temperature sensation loss

Superior Cerebellar Artery, or SCA

This artery serves the top part of the cerebellum. A stroke in this area can lead to

  • Ataxia
  • Dysarthria
  • Nystagmus
  • Vertigo
  • Headache
  • Vomiting


Therapeutic treatment following any type of stroke should always be individualized to the person. Because, as we know, symptoms will present differently.

With that said, typical therapeutic treatment for cerebellar strokes may revolve around postural and balance exercises, coordination activities, and sensory re-education (if the sensation of temperature and pain were impacted).

An example of a treatment combining balance exercises with coordination activities might be standing (maintaining upright posture) while passing an apple back and forth between your hands. This could be made more challenging by walking a few feet and transferring the apple back and forth as you walk.

Of note, please don’t try this at home if you have balance issues unless directed by a physician or your therapist.

I hope this helps give you a better understanding of the cerebellum, the effects of cerebellar strokes, and common therapeutic treatments.

If you’ve had a cerebellar stroke and your air traffic controller is not working properly, know that it can get better with time and lots of practice.