SELECTIVE DAMAGE TO THE CEREBELLAR VERMIS IN CHRONIC-ALCOHOLISM - A CONTRIBUTION FROM NEUROTOXICOLOGY TO AN OLD PROBLEM OF SELECTIVE VULNERABILITY

The curiously consistent localization of cerebellar cortical damage in chronic alcoholism is re-evaluated in the light of selective damage, with a similar topography in the cerebellar vermal region, in superfic ial siderosis in man and in experimental animals exposed to certain to xic substances. Attention is drawn to the capacity for Purkinje cell d endrites and Bergmann glia to extract materials from the CSF, and to t he close anatomical relationships of the susceptible lobules I-II, IX and X to the roof of the IVth ventricle and to the cistern of the grea t cerebral veins. This restriction of damage to vermis and paravermis may reflect some compartmentalization of CSF now within leptomeninges, consistently increasing exposure of these cerebellar surfaces to mate rials circulating in the CSF. In other circumstances when this pattern of damage is encountered it raises the question as to whether other e nvironmental agents, gaining access to the CSF, may be similarly distr ibuted.