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2011, Number 3

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Cir Cir 2011; 79 (3)

Microsurgical anatomy of the extracerebral segment of recurrent artery of Heubner in the Mexican population

Gasca-González OO, Delgado-Reyes L, Pérez-Cruz JC

Language: Spanish
References: 31
Page: 219-224
PDF size: 385.47 Kb.


ABSTRACT

Background: The recurrent artery of Heubner (RAH) is originated commonly from the anterior cerebral artery. Its extracerebral segment is directed toward the anterior perforate substance where it penetrates the cortex.
Methods: The RAH was dissected from 15 human brains from Mexican population, and the presence, length, branches, course and either RHAs or anterior communicating artery complex variants were reported.
Results: The RAH was found in 93% of the hemispheres and duplicated in 39% of the hemispheres. The RAH was duplicated in at least a hemisphere in 46.6% of the brains; 40% of the brains had a RAH in every hemisphere. It was duplicated in every hemisphere in 20%. A single artery at a hemisphere was found in 26.6% and double at the other hemisphere. With a length between 13.6 and 36.7 mm (mean: 24.2 mm) and giving rise to 1-9 branches (mean: 3.9 branches), the RAH originated from the juxtacommunicating segment in 44% of the cases, from A2 in 41%, from A1 in 5% and as a branch of the frontopolar artery in 10%. It had an oblique course in 38%, in L in 31%, sinuous in 18% and in inverted L in 13%. In 53.3% of the brains, some variant of the anterior communicating artery complex was found.
Conclusions: Because of the common anatomy of the RAH and its variants, we must consider the probability of finding it duplicated; therefore, it is necessary to make minute dissections of the region to locate or to secure the absence of the RAH.


REFERENCES

  1. Pearce JM. Heubner’s artery. Eur Neurol 2005;54:11-2114.

  2. Martínez BF, Sgarbi LN, Vergara ME, Laza NS, Almirón C, Spagnuolo DE, et al. Anatomía quirúrgica del sector extracerebral de la arteria de Heubner. Arch Neurocien 2003;8:16-22.

  3. Haroun RI, Rigamonti D, Tamargo RJ. Recurrent artery of Heubner: Otto Heubner’s description of the artery and his influence on pediatrics in Germany. J Neurosurg 2000;93:1084-1088.

  4. Riina HA, Lemole GM Jr, Spetzler RF. Anterior communicating artery aneurysms. Neurosurgery 2002;51:993-996.

  5. Loukas M, Louis RG Jr, Childs RS. Anatomical examination of the recurrent artery of Heubner. Clin Anat 2006;19:25-31.

  6. Miller S, O’Gorman AM, Shevell MI. Recurrent artery of Heubner infarction in infancy: case report. Dev Med Child Neurol 2000;42:344-346.

  7. Vitosević Z, Cetković M, Vitosević B, Jović D, Rajković N, Millisavljević M. Blood supply of the internal capsule and basal nuclei. Srp Arh Celok Lek 2005;133:41-45.

  8. Garner KM. Common neurologic disorders. En: Kaplow R, Hardin SR, eds. Critical Care Nursing: Synergy for Optimal Outcomes. Sudbury, MA: Jones & Bartlett Publishers; 2007. pp. 375-385.

  9. Gorczyca W, Mohr G. Microvascular anatomy of Heubner’s recurrent artery. Neurol Res 1987;9:259-264.

  10. Erbayraktar S, Tekinsoy B, Acar F, Acar U. Posttraumatic isolated infarction in the territory of Heubner’s and lenticulostriate arteries: case report. Kobe J Med Sci 2001;47:113-121.

  11. Weill A, Cognard C, Levy D, Robert G, Moret J. Giant aneurysms of the middle cerebral artery trifurcation treated with extracranialintracranial arterial bypass and endovascular occlusion. Report of two cases. J Neurosurg 1998;89:474-478.

  12. Sekhar LN, Natarajan SK, Britz GW, Ghodke B. Microsurgical management of anterior communicating artery aneurysms. Neurosurgery 2007;61:273-292.

  13. Andaluz N, Van Loveren HR, Keller JT, Zuccarello M. Anatomic and clinical study of the orbitopterional approach to anterior communicating artery aneurysms. Neurosurgery 2003;52:1140-1149.

  14. Jwa CS, Kim JM, Bak KH, Kim CH. Fusiform aneurysm of proximal anterior cerebral artery: case report. J Korean Neurosurg Soc 2003;33:199-200.

  15. Gupta SK, Khosla VK, Chhabra R, Mohindra S, Bapuraj JR, Khandelwal N, et al. Internal carotid artery bifurcation aneurysms: surgical experience. Neurol Med Chir 2007;47:153-158.

  16. Liu KD, Lee LS. Microsurgical treatment of deep arteriovenous malformations—basal ganglia and thalamus. Chin Med J 2001;64:23-30.

  17. Sasaki J, Miura S, Ohishi H, Kikuchi K. Neurofibromatosis associated with multiple intracranial vascular lesions: stenosis of the internal carotid artery and peripheral aneurysm of the Heubner’s artery; report of a case. No Shinkei Geka 1995;23:813-817.

  18. Gomes F, Dujovny M, Umansky F, Ausman JI, Diaz FG, Ray WJ, et al. Microsurgical anatomy of the recurrent artery of Heubner. J Neurosurg 1984;60:130-139.

  19. Suazo de la Cruz LE, Garbugino SL, Moreno GA, Lemme-Plaghos L. Evaluación anatomoangiográfica del complejo de la arteria comunicante anterior en casos de aneurismas de dicho sector. Rev Argent Neurocir 2002;16:1-10.

  20. Martínez F, Spagnuolo E, Calvo A. Aneurismas del sector distal de la arteria cerebral anterior (arteria pericallosa). Neurocirugia 2005;16:333-344.

  21. Perlmutter D, Rhoton AL Jr. Microsurgical anatomy of the anterior cerebral- anterior communicating-recurrent artery complex. J Neurosurg 1976;45:259-272.

  22. Aydin IH, Onder A, Takçi E, Kadioğlu HH, Kayaoğlu CR, Tüzün Y. Heubner’s artery variations in anterior communicating artery aneurysms. Acta Neurochir 1994;127:17-20.

  23. Pai S, Kulkarni R, Varma R. Microsurgical anatomy of the anterior cerebral artery-anterior communicating artery complex: an Indian study. Neurol Asia 2005;10:21-28.

  24. Tanriover N, Kawashima M, Rhoton AL, Ulm AJ, Mericle RA. Microsurgical anatomy of the early branches of the middle cerebral artery: morphometric analysis and classification with angiographic correlation. J Neurosurg 2003;98:1277-1290.

  25. Garza MR, Tamez MD, Martínez PLA, Morales GVD. Accessory middle cerebral artery associated with two intracranial aneurysms: case report. Arch Neurocien 2005;10:33-37.

  26. Martínez-Benia F, Sgarbi-López N, Spagnuolo-Dondero E, Prinzo- Yamurri H, Soria-Vargas VR. Arteria cerebral media accesoria: reporte de caso. Arch Neurocien 2002;7:156-160.

  27. Komiyama M, Nishikawa M, Yasui T. The accessory middle cerebral artery as a collateral blood supply. Am J Neuroradiol 1997;18:587-590.

  28. Tacconi L, Johnston F, Symon L. Accessory middle cerebral artery (case report). J Neurosurg 1995;83:916–918.

  29. Alkadhi H, Schuknecht B, Imhof HG, Yonekawa Y. Aneurysms at a temporopolar artery origin from the internal carotid artery: report of two cases. Neurosurgery 2003;52:1221-1225.

  30. Takahashi S, Hoshino F, Uemura K, Takahashi A, Sakamoto K. Accessory middle cerebral artery: is it a variant form of the recurrent artery of Heubner? Am J Neuroradiol 1989;10:563-568.

  31. Komiyama M, Nakajima H, Nishikawa M, Yasui T. Middle cerebral artery variations: duplicated and accessory arteries. Am J Neuroradiol 1998;19:45-49.




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