Heubner's artery variations in anterior communicating artery aneurysms

This study attempts to analyse the intra-operative anatomical findings of the recurrent artery of Heubner in 48 patients with Anterior Communicating Artery Aneurysm who were operated on at the Neurosurgical Department of Atatürk University Medical School, Erzurum, Türkiye. All patients underwent radical surgery for aneurysm by the right pterional approach. The findings were recorded during surgical intervention and through the dias and videotapes of the operations. The artery of Heubner originated from the junction of the A1 and A2 segments of the anterior cerebral artery (ACA) in 58%, from the A2 segment of ACA in 23%, and from the A1 segment of ACA 4%. It was asymmetrically taking off in 13% and hypoplastic in 2% of the cases. Three types of recurrent artery courses were defined. The type I or the superior course was seen in 71%, the type II or the anterior course was found in 25% and type III or the posterior course was recorded in 4% of patients. We concluded that the recognition of the anatomical variations of the recurrent artery of Heubner and the detailed knowledge of the microvascular relationships of the anterior communicating artery (ACoA) complex, will allow neurosurgeons to construct a better and safer microdissection plan, to save time, and so prevent postoperative neurological deficit.