Gomes F, Dujovny M, Umansky F, Ausman J I, Diaz F G, Ray W J, Mirchandani H G
J Neurosurg. 1984 Jan;60(1):130-9. doi: 10.3171/jns.1984.60.1.0130.
The recurrent arteries of Heubner were studied in 30 unfixed human brains (60 hemispheres) obtained from routine autopsies of individuals with a mean age of 34 years. The arteries were injected with tinted polyester resin via cannulation of the internal carotid arteries, and dissected under microscopic magnification. The recurrent artery of Heubner was absent in two hemispheres and double in seven hemispheres, either with a separate origin (in two) or from a common stem (in five). The artery of Heubner had a mean outer diameter of 0.8 +/- 0.04 mm (range 0.3 to 1.5 mm) and a mean length of 23.4 +/- 1.1 mm (range 12 to 38 mm). It originated from the A2 segment of the anterior cerebral artery (ACA) in 57% of the specimens, from the junction of the ACA and the anterior communicating artery in 35%, and from the A1 segment of the ACA in 8%. Three types of recurrent courses were observed. In the Type I or superior course, seen in 41 (63%) of the 65 arteries, the artery followed the superior wall of the A1 segment of the ACA. In the Type II or anterior course, the arteries found in 22 (34%) of specimens maintained a rostral position in relation to the A1 segment. In the Type III or posterior course, taken by two (3%) arteries, a posterior course of the vessel in the anterior perforated substance was found. The branching pattern was identified down to a range of 100 to 200 mu, and the average number of branches was 6.5 +/- 0.4 (range 3 to 12). Four groups of branches were observed. The olfactory group was represented in 91% by a single olfactory branch, with a mean outer diameter of 0.3 +/- 0.03 mm. On average, 1.9 +/- 0.27 frontal branches were found with a mean diameter of 0.13 +/- 0.01 mm. The branches penetrating the anterior perforated substance had a larger outer diameter (mean 0.4 +/- 0.03 mm) with an average number of 2.5 +/- 0.2 branches. The Sylvian fissure branches were more numerous (mean 3 +/- 0.3) with a mean outer diameter of 0.4 +/- 0.03 mm. The point of penetration of the main trunk was found to be constant at the level of the lateral perforated substance-medial Sylvian fissure in 85% of the cases. This report emphasizes the advantages of the intravascular casting resin injection technique in unfixed human brains over other conventional methods. It also describes the application of these anatomic data to the surgical strategy for the anterior circle of Willis, including the possible use of the recurrent artery of Heubner for microvascular reconstructive procedures.
对30个未固定的人脑（60个半球）进行了Heubner回返动脉的研究，这些人脑取自平均年龄为34岁个体的常规尸检。通过颈内动脉插管向动脉内注入有色聚酯树脂，并在显微镜放大下进行解剖。Heubner回返动脉在两个半球缺如，在七个半球为双支，其中两支有独立起源，五支起源于共同干。Heubner动脉的平均外径为0.8±0.04mm（范围0.3至1.5mm），平均长度为23.4±1.1mm（范围12至38mm）。在57%的标本中，它起源于大脑前动脉（ACA）的A2段，35%起源于ACA与前交通动脉的交界处，8%起源于ACA的A1段。观察到三种类型的走行。在I型或上行型中，65条动脉中有41条（63%）可见该动脉沿ACA A1段的上壁走行。在II型或前行型中，22个（34%）标本中的动脉相对于A1段保持在 Rostral 位置。在III型或后行型中，两条（3%）动脉走行于前穿质内，走行向后。分支模式确定到100至200μm范围，平均分支数为6.5±0.4（范围3至12）。观察到四组分支。嗅组91%由单一嗅支代表，平均外径为0.3±0.03mm。平均发现1.9±0.27条额叶支，平均直径为0.13±0.01mm。穿入前穿质的分支外径较大（平均0.4±0.03mm），平均分支数为2.5±0.2条。外侧裂支较多（平均3±0.3条），平均外径为0.4±0.03mm。在85%的病例中，主干的穿入点在外侧穿质-内侧外侧裂水平恒定。本报告强调了在未固定人脑中血管内铸型树脂注射技术相对于其他传统方法的优势。它还描述了这些解剖数据在 Willis 前循环手术策略中的应用，包括 Heubner 回返动脉在微血管重建手术中的可能应用。
