Microanatomy and possible clinical significance of anastomoses among hypothalamic arteries.

We examined anastomoses among the hypothalamic arteries in 14 human brains using an injection technique, microdissection, and a stereoscopic microscope. Five to 22 anastomoses (mean 10.1) were found in all 14 brains on each side, varying from 20 to 280 (mean 71) microns in diameter and from 0.1 to 5.3 (mean 1.52) mm long. A single hypothalamic artery may be connected to other vessels by one to 10 anastomoses. The anastomoses were channel-like or plexiform; both types may be ipsilateral or right-left. They connected the hypothalamic arteries "end-to-end," "end-to-side," and "side-to-side." The interconnected arteries ranged from 30 to 1,900 (mean 148) microns in diameter. Anastomoses were most frequent among the commissural arteries and in the distribution of the superior hypophyseal arteries and the tuberoinfundibular branches of the posterior communicating artery. The largest anastomoses were found among the tuberoinfundibular branches of the posterior communicating and internal carotid arteries, as well as among the premamillary arteries and the mamillary branches. We discuss the neurologic, neuroendocrinologic, and neurosurgical significance of the described anastomoses.