Recurrent artery of Heubner (also known as the medial striate artery or long central artery) is the largest perforating branch from the proximal anterior cerebral artery, and is the only one routinely seen on angiography. Its origin is near the A1-ACOM-A2 junction of the anterior cerebral artery, arising from the proximal A2 in 90% of cases, and from the distal A1 in 10% of cases. It then curves back sharply on itself, paralleling the A1 and is at risk from ACOM aneurysm clipping (see case 1).

It supplies the head of caudate, paraterminal gyrus, anterior portion of the lentiform nucleus and anterior limb of the internal capsule.

Clinical manifestationsUnilateral occlusionweakness contralateral armweakness contralateral facedysarthriahemichoreaBilateral occlusionakinetic mutismAnatomical variationsIt may be absent in 3% or duplicated in 12% of individuals.

History and etymologyIt is named after Johann Otto Leonhard Heubner: German paediatrician (1843-1926)

NB: The perforating branches from the ACA should not be confused with the medial lenticulostriate arteries which arise from the MCA.