Right cerebellar infarct demonstrating luxury perfusion

Findings

CT shows right cerebellar hemispheric hypoattenuation with edema, mass effect, and effacement of the 4th ventricle. Angiogram shows contrast blush in the right inferior cerebellar hemisphere with an early draining vein ("luxury perfusion"). Anterior and inferior displacement of the right PICA branch. No evidence of vertebral dissection or vascular malformation.


Diagnosis: Right cerebellar infarct demonstrating luxury perfusion


Key points

Luxury perfusion is a term used to describe increased circulation through an area of infarcted brain.
Thought to be due do vasodilation secondary to lowered oxygen tension and decrease tissue pH. (Loss of normal CBF autoregulation).
Angiographically seen as capillary blush and early filling of local veins.
The blush may simulate a tumor
Luxury perfusion can be seen in minutes to hours after infarction, usually resolves in 3-5 days. Never seen after 2 weeks.