Recurrent artery of Heubner Infarct

Syn: Long central artery, Medial striate artery.

A largest medial lenticulostriate perforating branch arising from ACA.
Arises from the A2 segment in most ~57–78% of cases, may arise from A1 segment in up to ~17% of cases and from the ACA-A-comm junction in 35% of cases.
Called ‘Recurrent’ because it takes U turn after its origin, goes ‘back’ laterally over A1, parallel to A1 and in opposite direction of A1, towards the terminal ICA, so it often looks like a smaller artery running alongside and above the relatively bigger A1.

Ascends up to enter the lateral anterior perforated substance to supply head of caudate nucleus, anterior limb of the internal capsule and the anterior third of the putamen.
The artery is not large enough to be seen on MR Angiography, usually seen on DSA. Often encountered during surgery of the A1 - Acom complex, occlusion of the vessel possible during retraction of the frontal lobe.
Isolated infarction in the vascular territory of this artery can be clinically silent or produce a hemiparesis that is most prominent in the face and upper extremity.

Infarct in territory of Recurrent artery of Heubner involving caudate nucleus, anterior limb of the internal capsule and the anterior third of the putamen 

Reference: Handbook of Cerebrovascular Disease and Neurointerventional Technique.  Mark R. Harrigan, John P. Deveikis and Agnieszka Anna Ardelt.