Anatomical Variations in the Origin of the Recurrent Artery of Heubner and Its Clinical Importance – A Cadaveric Study

Background: The recurrent artery of Heubner (RAH) is one of the prominent medial lenticulostriate arteries. RAH takes its origin in close proximity to the anterior cerebral artery (ACA)–anterior communicating artery (ACoA) junction. RAH supplies the medial part of the orbitofrontal cortex, corpus striatum, olfactory region, anterior limb of the internal capsule, and anterior hypothalamus. Involvement of RAH in pathological conditions such as atheroma may result in serious complications such as hemiparesis, aphasia, facial paralysis, and behavior changes. Surgical interventions performed on the anterior circle of Willis (CW) can be affected/complicated by the morphology of RAH. Hence, it is important to know the anatomical variations of the origin of RAH. Materials and Methods: In the present study, 60 formalin-fixed cerebral hemispheres were superficially dissected. The origin of RAH from various segments of ACA such as A1, A2, and A1-ACoA junction was noted. Results: RAH was identified in 16 out of 60 hemispheres. It arose from the A1 segment in 1 specimen (6.25%), A1-ACoA junction in 11 specimens (68.75%), and A2 segment in 4 specimens (25%). RAH was seen unilaterally in 8 specimens and bilaterally in 4 specimens. The bilateral origin of RAH was seen as symmetrical as well as asymmetrical. Conclusion: Knowledge of RAH is important to prevent postoperative neurological deficits during neurosurgical procedures that are performed close to the anterior segment of CW.