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Purpose: The recurrent artery of Heubner (RAH) is a very fascinating artery for various reasons. The first one is its early development in the embryologic and phylogenic life. The second one is the discrepancy between its diameter and its functional importance and the last but not least reason is the many variations of origin and course of this artery., Methods: For more than a century, numerous studies furnished important information about variations in origin, course, and parenchymal territory of the RAH. The most important anomaly concerning the RAH is the accessory middle cerebral artery and well-illustrates the complexity of its embryologic development., Conclusion: For these reasons, authors provide a review of anatomical variations of this artery that could be encountered with a particular attention given to the history and embryological knowledge.

The purpose of this study has been to describe the microanatomy of the recurrent artery of Heubner (RAH) in detail, to deepen anatomical knowledge and aid neurosurgeons in their work. The material was obtained from cadavers (ages 31-75 years) at routine autopsy. A total of 70 human brains (39 male and 31 female) were examined. People who died due to neurological disorders were not included in the study. Right after dissection, the arteries were perfused with acrylic paint emulsion, through the Circle of Willis or electively through the RAH. Brains were fixed in a 10% solution of formaldehyde, sectioned and placed in methyl salicylate for tissue transparency. To obtain corrosion-casts, the vessels were perfused with polyvinyl chloride or Mercox CL-2R resin and corroded using concentrated potassium chloride. The obtained material was analyzed using a stereoscopic light microscope. 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. Two to 30 branches (mean=9.4) originated from the stem of the RAH. The number of RAHs showed a negative correlation to the number of arteries from the medial group of lenticulo-striate arteries (LSA) (R=-0.62; p < 0.0001) which branch off the middle cerebral artery (MCA). This study further supports the RAH embryologic theory by Abbie. The RAH, in its extra- and intracerebral course, may join with the middle group of the LSA or directly with the MCA., (Copyright © 2013 Elsevier GmbH. All rights reserved.)

Development of cerebral perivascular nerves immunoreactive for vasoactive intestinal polypeptide (VIP) was investigated in the Japanese quails, using immunohistochemistry and quantitative analysis. VIP-immunoreactive (VIP-IR) nerves supplying the anterior circulation appeared on the cerebral carotid artery (CCA) at embryonic day 10 and on the cerebroethmoidal artery (CEA) after hatching. Nerves from the CCA increased greatly in number and spread progressively during successive embryonic stages, while those from the CEA were sparse all through the post-hatching stages, mostly remained limited to this vessel wall. The distribution of VIP-IR nerves to the respective major arteries of the anterior circulation from the two vascular routes was basically similar among post-hatching day (P) 15, P20, P30 and P50. Likewise, no clear statistical difference was observed with regard to the nerve density of the corresponding arteries in the four age groups. These findings suggest that VIP-IR innervation of the quail anterior circulation usually attains its mature pattern at the third week after hatching.

Object: The authors describe some of the features of the medial striate branch or recurrent artery of Heubner (RAH). This structure has indisputable functional, neurological, and neurosurgical significance, and originates from the A(1) and/or A(2) segments of the anterior cerebral artery., Methods: Microdissection of 94 human fetal specimens was performed. The RAH was observed in 97.3% (single in 71.6%, double in 25.1%, and triple in 3.3%) of the cases. Its origin was from A(2) in 42.3% of specimens, from the A(1)-A(2) junction in 25.7%, and from A(1) in 20%., Results: Five types and 14 subtypes of the RAH were identified, determined based on vessel origin and number. In its course, the RAH gave 1-12 branches, and the terminal part most frequently penetrated into the brain through the anterior perforated substance at the level of the sphenoid segment of the middle cerebral artery. The specimens with a single RAH fenestration, abnormal double RAH anastomosis, and unusual RAH origin and relationship to the surrounding vessels represented new data., Conclusions: The authors' observations of common anatomical variations in the number and origin of the RAH, as well as its abnormalities, may assist neuroradiologists in the interpretation of diagnostic test results and neurosurgeons in performing procedures in the anterior cerebral circulation.

Background: Although centuries of the human CAC research are behind us, still there is a stimulus for the authors to describe something new or to add to the "archive" of already known facts about its angioarchitecture., Methods: With normal configurations of the posterior part of the CAC in early prenatal status, 172 brains of human fetuses from the 13th to the 24th week were used in the purpose of investigation. Brain arteries were injected and microdissected using a surgical microscope., Results: According to diameter values of vascular components in the posterior part of the CAC, 6 basic types and the corresponding number of their subtypes are formed. Incidences of bilateral transitory (18.6%), fetal (9.3%), and adult (33.1%) types, as well bilateral asymmetric types (fetal-transitory in 5.8%, adult-transitory in 14.5%, and adult-fetal in 18.6% of cases), proved that dominant configuration of posterior part had not been present in the period from the fourth to the sixth gestational month., Conclusion: The finding of normal subtypes of the posterior part of the CAC, as well as the absence of some subtypes, is a challenge for future studies of the posterior arterial pattern within vascular abnormalities or diseases.

An unpaired trunk forming part of the anterior cerebral arteries, the so-called azygos pericallosal artery, was found in a male fetus among a collection of 200 fetuses. The morphological characteristics of the trunk and the anterior cerebral arteries at the "preazygos" and the "postazygos" segments were examined using an operating microscope. The azygos pericallosal artery distributes into three postazygos segments of which only the median postazygos segment or median callosal artery had a bihemispheric distribution of its branches to the medial telencephalic surfaces.

We monitored changes in caliber, position and branching of blood vessels in fetuses of 4 - 9 months of intrauterine life. By precise dissection we prepared starting parts of common carotid artery and internal jugular vein in 40 cadaver fetuses. The vessels were injected with Telebrix and subjected to postmortem angiography at the Institute of Radiology Clinics Center in Sarajevo. Thereafter, arteries obtained were compared and analyzed. In preparations of few months old fetal material we observed arteries of fairly straight course, low caliber and with no observable ramification. When preparations of more mature stillborn infants were examined, we detected arteries of undulating course, more expressed ramification and higher caliber. In stillborn babies, all three arteries are of high caliber with rich branching. Considering that in this phase of brain development sulcuses are relatively wide, we can say that course of arteries is partially tortuous. Analysis of venous vessels shows good distinction of venous sinuses and subarachnoidal cisterns. We can conclude with great certainty that the changes occur in position, caliber and relationship among vessels in fetus during the period of brain sulci and gyri formation.

Although absence of the common carotid artery (CCA) is a rare anomaly, the specific configuration in our case makes it extremely rare. Clinical, angiographic, ultrasonographic, and embryologic correlations of this anomaly are discussed after the case report.

We report a case of a 24-week-old fetus with cerebral anomalies suggestive of lobar holoprosencephaly including an unusual course of the anterior cerebral artery on Doppler examination. This abnormal trajectory of the anterior cerebral artery in holoprosencephalic brains has been described by pathologists, neurosurgeons and radiologists but our case indicates that this finding may be a useful adjunct to confirm such a difficult diagnosis prenatally.