Topics

Topic

design image
Long medial striate artery

The Long Medial Striate Artery, also known as the Recurrent Artery of Heubner, is a prominent perforating branch of the anterior cerebral artery. It plays a vital role in supplying deep cerebral structures, particularly parts of the basal ganglia and internal capsule. Its clinical significance is highlighted by its susceptibility to infarction, which can result in distinctive neurological deficits. Due to its small size, it is best appreciated using advanced neuroimaging techniques.

Synonyms

  • Recurrent artery of Heubner

  • Heubner’s artery

  • Medial striate artery (long)

  • Long central artery of the anterior cerebral artery

Origin

  • Most commonly arises from the anterior cerebral artery (ACA), specifically from the proximal segment of the A2 segment (post-communicating part), just distal to the anterior communicating artery.

  • Less frequently, it may originate from the A1 segment (pre-communicating part) or directly at the anterior communicating artery junction.

Course

  • After originating from the ACA, the artery runs posteriorly and laterally.

  • It loops back toward the base of the brain, passing through the anterior perforated substance.

  • The artery then penetrates the brain to supply deep structures, especially in the region of the basal ganglia.

  • It typically courses parallel and medial to the lenticulostriate arteries from the middle cerebral artery, but supplies more medial regions.

Function (Supply)

  • Supplies blood to the following structures:

    • Head of the caudate nucleus

    • Anterior limb of the internal capsule

    • Putamen (anteromedial part)

    • Globus pallidus (anteromedial part)

    • Anterior hypothalamus (occasionally)

  • Its vascular territory is critical for motor and executive functions due to the involvement of the basal ganglia and internal capsule.

  • Infarction can result in contralateral motor deficits and other characteristic syndromes.

MRI Appearance

  • Normal: The artery itself is typically not visualized on standard MRI due to its small size.

  • Pathology: Acute infarction in its territory appears as restricted diffusion (high signal on DWI, low on ADC) in the head of the caudate and anterior limb of the internal capsule.

  • MR Angiography (MRA): May rarely visualize the artery as a tiny branch arising from the ACA.

  • High-resolution MRI (3T or higher): May occasionally delineate the vessel in specialized sequences.

CT Appearance

  • Normal: The artery is not visible on conventional CT due to its small caliber.

  • Pathology: Infarction in its territory is seen as hypodensity in the head of the caudate and anterior limb of the internal capsule on non-contrast CT.

  • CT Angiography: Rarely, a faint linear branch may be seen with high-quality, thin-section imaging, but usually not clearly visualized.

MRI image

Long medial striate artery (recurrent artery of Heubner) MRI 3T sagittal image