Microsurgical anatomy of distal medial striate artery (recurrent artery of Heubner)

Abstract

Iatrogenic damage or occlusion leads to a mediobasal striatum infarction with important neurological deficits such as brachiofacial hemiparesis and aphasia. This artery should be routinely identified during clipping of ACoA aneurysm. Special attention in this study was given to atypical posterior course or anatomic variations such as double DMSA on a same side.

The Variable Origin of the Recurrent Artery of Heubner: An Anatomical and Morphometric Study

“…The microsurgical report of Zunon-Kipré et al concluded that A2 is the most common origin of RAH (58% of cases). The RAHs were more often originated from A1, in 30% of cases, than at the ACA-ACoA junction, in 12% of cases [3]. Similar conclusion was shown in the study of Perlmutter and Rhoton on 50 adult brains.…”

“…The different organization of these channels can be the result of the variable origin, number, size, or course of the artery. The RAH is a branch from the primitive olfactory artery as the ophthalmic artery, the anterior choroid artery, and the MCA [3]. The artery is well developed at the twenty-fourth week of gestation [5].…”

“…Various terms were used to sign this artery. It was named as the anterior striate artery, the long telencephalic artery, or the long centralis artery [3]. The latest anatomical nomenclature marked the vessel as the distal medial striate artery [4].…”

“…The course of the RAH is closely related to the posterior portion of the orbitofrontal cortex and mainly to the gyrus rectus [6, 8]. The artery passes inferiorly and laterally to the origin of olfactory striae before reaching the anterior perforating substance [3]. …”

“…The artery also supplies the olfactory region, the anterior hypothalamus, the nucleus accumbens, parts of the uncinate fasciculus, the diagonal band of Broca, and the basal nucleus of Meynert [3, 8, 10–12]. …”