Luxury perfusion
Updates to Article Attributes
Luxury perfusion or hyperperfusion describes the return of cerebral blood flow to normal or increased levels in regions of infarcted brain (and thus has been termed "non-nutritional") and is thought to occur secondary to blood-brain barrier permeability and dysfunctional autoregulation 1-4. It most commonly occurs in subacute strokes (>72 hours), both treated and untreated cases, but has been reported as early as within the first 24 hours 1,2,4.
Radiographic features
CT
CT perfusion will demonstrate these regions to have elevated and cerebral blood flow (CBF) and cerebral blood volume (CBV) as well as prolonged. meanMean transit time (MTT) and time to peak (TTP) are variable 1,6.
The corresponding non-contrast CT or MRI should show changes of an established stroke 1.
Differential diagnosis
Patients presenting with stroke-like symptoms post-seizure (e.g. Todd paresis) can have a similar pattern of hyperperfusion with increased CBV and CBF, however, unlike in cases of luxury perfusion, have lower (shorter) MTT and shortened MTT 3,5.
It should be noted that this is generally seen in status epilepticus or when scanned during seizures. In the post-ictal phase, CBV and CBF are decreased and MTT somewhat prolonged 5.
-<p><strong>Luxury perfusion</strong> or <strong>hyperperfusion </strong>describes the return of cerebral blood flow to normal or increased levels in regions of <a href="/articles/ischaemic-stroke">infarcted brain</a> (and thus has been termed "non-nutritional") and is thought to occur secondary to <a href="/articles/blood-brain-barrier-3">blood-brain</a><a href="/articles/blood-brain-barrier-3"> barrier</a> permeability and dysfunctional autoregulation<sup> 1-4</sup>. It most commonly occurs in subacute strokes (>72 hours), both treated and untreated cases, but has been reported as early as within the first 24 hours <sup>1,2,4</sup>. </p><h4>Radiographic features</h4><h5>CT</h5><p><a href="/articles/ct-perfusion-in-ischaemic-stroke">CT perfusion</a> will demonstrate these regions to have elevated and <a href="/articles/cerebral-blood-flow-cbf">cerebral blood flow (CBF)</a> and <a href="/articles/cerebral-blood-volume-cbv">cerebral blood volume (CBV)</a> as well as prolonged <a href="/articles/mean-transit-time-mtt">mean transit time (MTT)</a> and <a href="/articles/time-to-peak-ttp-2">time to peak (TTP)</a>.</p><p>The corresponding non-contrast CT or MRI should show changes of an established stroke <sup>1</sup>. </p><h4>Differential diagnosis</h4><p>Patients presenting with stroke-like symptoms post-seizure (e.g. <a href="/articles/todd-paresis">Todd paresis</a>) can have a similar pattern of hyperperfusion with increased CBV and CBF, however, unlike in cases of luxury perfusion, have lower (shorter) MTT <sup>3,5</sup>. It should be noted that this is generally seen in <a title="Status epilepticus" href="/articles/status-epilepticus">status epilepticus</a> or when scanned during seizures. In the post-ictal phase, CBV and CBF are decreased and MTT somewhat prolonged <sup>5</sup>. </p>- +<p><strong>Luxury perfusion</strong> or <strong>hyperperfusion </strong>describes the return of cerebral blood flow to normal or increased levels in regions of <a href="/articles/ischaemic-stroke">infarcted brain</a> (and thus has been termed "non-nutritional") and is thought to occur secondary to <a href="/articles/blood-brain-barrier-3">blood-brain</a><a href="/articles/blood-brain-barrier-3"> barrier</a> permeability and dysfunctional autoregulation<sup> 1-4</sup>. It most commonly occurs in subacute strokes (>72 hours), both treated and untreated cases, but has been reported as early as within the first 24 hours <sup>1,2,4</sup>. </p><h4>Radiographic features</h4><h5>CT</h5><p><a href="/articles/ct-perfusion-in-ischaemic-stroke">CT perfusion</a> will demonstrate these regions to have elevated and <a href="/articles/cerebral-blood-flow-cbf">cerebral blood flow (CBF)</a> and <a href="/articles/cerebral-blood-volume-cbv">cerebral blood volume (CBV)</a>. <a href="/articles/mean-transit-time-mtt">Mean transit time (MTT)</a> and <a href="/articles/time-to-peak-ttp-2">time to peak (TTP)</a> are variable <sup>1,6</sup>.</p><p>The corresponding non-contrast CT or MRI should show changes of an established stroke <sup>1</sup>. </p><h4>Differential diagnosis</h4><p>Patients presenting with stroke-like symptoms post-seizure (e.g. <a href="/articles/todd-paresis">Todd paresis</a>) can have a similar pattern of hyperperfusion with increased CBV and CBF and shortened MTT <sup>3,5</sup>.</p><p>It should be noted that this is generally seen in <a href="/articles/status-epilepticus">status epilepticus</a> or when scanned during seizures. In the post-ictal phase, CBV and CBF are decreased and MTT somewhat prolonged <sup>5</sup>. </p>
References changed:
- 6. Sotoudeh H, Shafaat O, Singhal A, Bag A. Luxury Perfusion: A Paradoxical Finding and Pitfall of CT Perfusion in Subacute Infarction of Brain. Radiol Case Rep. 2019;14(1):6-9. <a href="https://doi.org/10.1016/j.radcr.2018.08.031">doi:10.1016/j.radcr.2018.08.031</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30294403">Pubmed</a>
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