Embolic shower and recurrent artery of Heubner infarct
Left hemispheric seizure with secondary generalisation. ? seizure focus.
Loading Stack -
0 images remaining
Examination demonstrates an acute stroke with prominent diffusion signal abnormality and matching diffusion restriction, affecting the right recurrent artery of Heubner involving the head of the right caudate nucleus, right anterior cerebral artery pericallosal branch along the right cingulate gyrus and medial right frontal cortex, right middle cerebral artery superior division involving supra Sylvian lateral frontal and parietal cortex, infarction involving the splenium of the corpus callosum to the left of midline, infarct involving the medial left temporal lobe hippocampal and parahippocampal hippocampal gyri.
1 case question available
The MRI brain showed multiple embolic strokes also known as an embolic shower.
Embolic stroke may arise from cardiac sources such as atrial fibrillation (which is considered the major source of cardioembolic stroke), thrombus formation in an enlarged left cardiac chamber (aneurysm), in the presence of right-to-left shunt (paradoxical embolism), from valvular surface releasing abnormal materials (endocarditis) and thrombus from the vessel supplying the brain ( Internal carotid artery).
Recurrent artery of Heubner (RAH) is the largest perforating branch of the proximal anterior cerebral artery (ACA), arising from the proximal A2 in 90% of cases, and from the distal A1 in 10% of cases. It is single in 96.22 % of cases, double in 2.38 % of cases and triple in 0.14 % of cases. Postoperative infarctions following surgical repair of the anterior communicating artery (ACOM) aneurysms is very frequently. RAH supplies the head of the caudate nucleus, paraterminal gyrus, anterior portion of the lentiform nucleus and anterior limb of the internal capsule.
- Shunji Mugikura, Hirokazu Kikuchi, Miki Fujimura, Etsuro Mori, Shoki Takahashi, Kei Takase. Subcallosal and Heubner artery infarcts following surgical repair of an anterior communicating artery aneurysm: a causal relationship with postoperative amnesia and long-term outcome. (2018) Japanese Journal of Radiology. 36 (2): 81. doi:10.1007/s11604-017-0703-2 - Pubmed
- Wakoto Matsuda, Takahiro Sonomura, Satoru Honma, Sachi Ohno, Tetsuya Goto, Shuichi Hirai, Masahiro Itoh, Yoshiko Honda, Hiroki Fujieda, Jun Udagawa, Shuichi Ueda. Anatomical variations of the recurrent artery of Heubner: number, origin, and course. (2017) Anatomical Science International. doi:10.1007/s12565-017-0415-9 - Pubmed