The recurrent artery of Heubner in routine selective cerebral angiography

Heubner's recurrent artery (RAH) in brain selective catheter angiograms (digital subtraction angiography, DSA) was evaluated.

Bilateral cerebral angiograms with antero-posterior, lateral and oblique frontal views were obtained in 100 neurological patients aged from 5 to 90 years. Site of origin, type of course and branching of the RAH were studied. Three groups were obtained: arteries with solely the horizontal segment visible, horizontal and vertical segments visible and horizontal and vertical with intraparenchymal branches visible.

A total of 24 RAHs were recognised in 20 patients: 7 arose from the A1, 5 from the anterior cerebral artery (ACA)-anterior communicating artery (Acom), 11 from the A2, whereas in 1 case, the segment of origin from the ACA could not be identified. Seventeen arteries arose from the lateral wall of the ACA and seven from the superior wall of the A1 segment of the ACA. The RAH was bilaterally seen in 3 patients and unilaterally in 17 with one double RAH. Five RAHs were visible only after contrast injection in the contralateral internal carotid artery. A horizontal segment was visible in 7 arteries, a horizontal followed by a vertical segment without visible intraparenchymal branching pattern was seen in 6 and a horizontal and vertical segment with visible intraparenchymal branching pattern was seen in 11. In five, the artery made a half loop with an inferior-convex curve just before the vertical segment, and in two cases, a full loop was observed.

The RAH was recognised in 12% of the hemispheres of the present series of neurological patients studied with DSA.