Maga P, Tomaszewski K A, Pasternak A, Zawiliński J, Tomaszewska R, Gregorczyk-Maga I, Skrzat J
Folia Morphol (Warsz). 2013 May;72(2):94-9. doi: 10.5603/fm.2013.0016.
The aim of the current study was to analyse the extra- and intracerebral course of the recurrent artery of Heubner (RAH) to provide detailed information for neurosurgeons operating in this area.
The material for this study was obtained from cadavers (ages 31-75 years) during routine autopsies. A total of 70 human brains (39 male and 31 female) were examined. The material was collected not later than 48 h post-mortem. People who died due to neurological disorders were not included into the study. Right after dissection the arteries were perfused with either acrylicpaint emulsion, polyvinyl chloride or Mercox CL-2R resin, through the Circle of Willis or electively through the RAH. The obtained material was analysed using a stereoscopic light microscope, magnification 2-40´.
The RAH was present in 138 hemispheres with a mean of 1.99 RAH per hemisphere (275 RAH in total). The mean RAH length was 25.2 mm and the mean RAH diameter, in its place of origin, was 1 mm. In 168 (61%) cases the RAH ran superiorly, in 88 (32%) cases anteriorly, in 11 (4%) cases inferiorly and in 8 (3%) cases posteriorly to the A1 segment. In 70.2% of the cases the course of the RAH was parallel to the anterior communicating artery A1 segment, and in 29.8% of the cases the RAH arched towards the olfactory tract. As the extracerebral course of the RAH was always tortuous,its length was 1 to 5 times the distance between its place of origin and the most lateral point of anterior perforated substance (APS) penetration. The intracerebral course of the RAH was almost always univectorial - towards the head of the caudate nucleus.The course of RAH branches depended on their number. When the number of RAH sand their branches was low, they separated immediately after penetrating the APS and formed multiple small branches. When the number of RAHs and branches was high,post-APS branching was less frequent and occurred in distal segments.
The origin and course of the RAH is highly variable. The RAH, in its extra- and intracerebral course, may join with the middle group of the lenticulostriate arteries or directly with the middle cerebral artery. This artery should be routinely identified during anterior communicating artery aneurysm clipping to prevent postoperative neurological deficits.
本研究旨在分析Heubner回返动脉（RAH）在脑外和脑内的走行，为在此区域进行手术的神经外科医生提供详细信息。
本研究材料取自常规尸检的尸体（年龄31 - 75岁）。共检查了70个大脑（39例男性和31例女性）。材料在死后48小时内收集。因神经系统疾病死亡的人未纳入本研究。解剖后立即通过 Willis 环或选择性地通过RAH用丙烯酸漆乳液、聚氯乙烯或Mercox CL - 2R树脂灌注动脉。使用放大倍数为2 - 40倍的立体光学显微镜对获得的材料进行分析。
138个半球存在RAH，每个半球平均有1.99条RAH（总共275条RAH）。RAH的平均长度为25.2毫米，其起源处的平均直径为1毫米。在168例（61%）中，RAH走行于A1段上方，88例（32%）走行于前方，11例（4%）走行于下方，8例（3%）走行于后方。在70.2%的病例中，RAH的走行与前交通动脉A1段平行，在29.8%的病例中，RAH向嗅束呈弓形走行。由于RAH的脑外走行总是迂曲的，其长度是其起源处与前穿质（APS）最外侧穿透点之间距离的1至5倍。RAH的脑内走行几乎总是单向量的——朝向尾状核头部。RAH分支的走行取决于其数量。当RAH及其分支数量较少时，它们在穿透APS后立即分开并形成多个小分支。当RAH及其分支数量较多时，APS后的分支较少且发生在远端节段。
RAH的起源和走行高度可变。RAH在其脑外和脑内走行过程中，可能与豆纹动脉中间组或直接与大脑中动脉相连。在夹闭前交通动脉瘤时应常规识别该动脉，以防止术后神经功能缺损。
