Recurrent artery of Heubner

Last revised by Craig Hacking on 14 Aug 2023

Recurrent artery of Heubner, also known as the medial striate artery or long central artery, is the largest perforating branch from the proximal anterior cerebral artery (ACA) and is the only one routinely seen on angiography.

Its origin is near the A1-ACom-A2 junction of the ACA, arising from the proximal A2 in 90% of cases, and from the distal A1 in 10% of cases. Rarely, it can arise from ACom or have a common origin with the frontopolar artery. It then curves back sharply on itself (hence it's name), paralleling the A1 and is at risk from ACom aneurysm clipping (see case 1).

The recurrent artery of Heubner provides vascular supply mainly to 8:

It may be absent in 3% or duplicated in 12% of individuals. In some patients it may be triplicated 9 or even quadruplicated 8

It is named after Johann Otto Leonhard Heubner, a German pediatrician (1843-1926), who first described his eponymous vessel in 1872 7.

Clinical manifestations of occlusion include

  • unilateral

    • weakness contralateral arm

    • weakness contralateral face

    • dysarthria

    • hemichorea

  • bilateral: akinetic mutism

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Cases and figures

  • Figure 1: anterior circle of Willis
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  • Case 1: infarct
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  • Case 2: infarct
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  • Case 3: infarct
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