The orbitofrontal artery is a cortical branch of the anterior cerebral artery arising at the A2 level near the genu of the corpus callosum, running anterolaterally to supply the orbital surface of the frontal lobe (Brodmann areas 11 and 47 — the orbitofrontal cortex). It is one of the first cortical branches of the ACA after leaving the anterior communicating artery complex, supplying the medial and orbital frontal lobe and the olfactory tract region.
The orbitofrontal artery territory is involved in ACA infarction involving the medial frontal lobe, contributing to the personality changes, executive dysfunction, and emotional dysregulation that characterise orbitofrontal cortex damage. Olfactory groove and anterior skull base meningiomas may be supplied by the orbitofrontal artery branches, and their sacrifice during surgery produces orbitofrontal cortex infarction. The orbitofrontal cortex is a key target in deep brain stimulation and neuromodulation for psychiatric disorders including OCD and major depression.
Orbitofrontal artery territory infarction from ACA occlusion or anterior skull base surgery produces orbitofrontal cortex damage with impaired reward processing, decision-making deficits, emotional disinhibition, and anosmia from olfactory tract involvement; the personality and behavioural changes are often more disabling than the focal neurological deficits.
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