Recurrent artery of Heubner
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View Donna D'Souza's current disclosuresAt the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.
View Rohit Sharma's current disclosures- Medial striate artery
- Recurrent artery of Huebner
- Long central artery
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.
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Gross anatomy
Origin and course
The origin is from the anterior cerebral artery at the A1-A2 junction (level of the anterior communicating artery) or within a few millimeters in the proximal A2 segment in 90% of cases 10. The specific distribution varies by study 8,9. The remainder originate from the A1 segment. Rarely, it can have a common origin with the orbitofrontal artery, which is otherwise usually the second branch of the A2 segment 5.
The artery then curves back sharply on itself (hence its name), paralleling the A1 and is at risk during anterior communicating artery aneurysm clipping (see case 1).
Supply
The recurrent artery of Heubner provides vascular supply mainly to the following brain structures 8:
head of the caudate nucleus
medial portion of globus pallidus
anterior limb of the internal capsule
anterior hypothalamus
parts of the uncinate fasciculus
Variant anatomy
It may be absent in 3% or duplicated in 12% of individuals. In some patients it may be triplicated 9 or even quadruplicated 8.
History and etymology
It is named after Johann Otto Leonhard Heubner, a German pediatrician (1843-1926), who first described this vessel in 1872 7.
Related pathology
Clinical manifestations of occlusion include
-
unilateral
weakness contralateral arm
weakness contralateral face
dysarthria
hemichorea
bilateral: akinetic mutism
Quiz questions
References
- 1. Anne G. Osborn, Karen A. Tong. Handbook of Neuroradiology. (1996) ISBN: 9780815165934 - Google Books
- 2. Hans-Joachim Kretschmann, Wolfgang Weinrich. Cranial Neuroimaging and Clinical Neuroanatomy. (2004) ISBN: 9781588901453 - Google Books
- 3. Julien Bogousslavsky. Stroke Syndromes. (2001) ISBN: 9780521771429 - Google Books
- 4. Eelco F. M. Wijdicks. Catastrophic Neurologic Disorders in the Emergency Department. (2004) ISBN: 9780195168808 - Google Books
- 5. Lee E & Eastwood J. An Unusual Variant of the Fronto-Orbital Artery. AJNR Am J Neuroradiol. 2000;21(5):939-40. PMC7976767 - Pubmed
- 6. Takahashi S, Suzuki M, Matsumoto K et al. Extent and Location of Cerebral Infarcts on Multiplanar MR Images: Correlation with Distribution of Perforating Arteries on Cerebral Angiograms and on Cadaveric Microangiograms. AJR Am J Roentgenol. 1994;163(5):1215-22. doi:10.2214/ajr.163.5.7976904 - Pubmed
- 7. Haroun R, Rigamonti D, Tamargo R. Recurrent Artery of Heubner: Otto Heubner's Description of the Artery and His Influence on Pediatrics in Germany. J Neurosurg. 2000;93(6):1084-8. doi:10.3171/jns.2000.93.6.1084 - Pubmed
- 8. El Falougy H, Selmeciova P, Kubikova E, Haviarová Z. The Variable Origin of the Recurrent Artery of Heubner: An Anatomical and Morphometric Study. Biomed Res Int. 2013;2013:873434. doi:10.1155/2013/873434 - Pubmed
- 9. Matsuda W, Sonomura T, Honma S et al. Anatomical Variations of the Recurrent Artery of Heubner: Number, Origin, and Course. Anat Sci Int. 2018;93(3):317-22. doi:10.1007/s12565-017-0415-9 - Pubmed
- 10. Bonasia S, Bojanowski M, Robert T. Embryology and Variations of the Recurrent Artery of Heubner. Anatomy of Cranial Arteries, Embryology and Variants. 2023;:105-15. doi:10.1007/978-3-031-32913-5_10
Incoming Links
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- Internal capsule
- Medial lenticulostriate arteries
- Brain arterial vascular territories
- Nucleus accumbens
- Watershed cerebral infarction
- Lacunar infarct
- Anterior cerebral artery
- Caudate nucleus
- Accessory middle cerebral artery
- Striatocapsular infarct
- Cistern of the lamina terminalis
- Lateral lenticulostriate arteries
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