Table 1 Pattern-based approach to GRD
From: Gyriform restricted diffusion in adults: looking beyond thrombo-occlusions
Aetiology | Pattern | Cortical predilection | T2 signal | GRE susceptibility | PGE | Other involvement |
|---|---|---|---|---|---|---|
HIE | B/L, symmetric | Perirolandic, occipital cortex | + | +/− | − | Basal ganglia, thalami, cerebellum |
Post-ictal | U/L or B/L, diffused or localised | Any lobe, +/− hippocampus | ++ | − | +/− | +/− Splenium |
Hypoglycaemia | B/L, symmetric > asymmetric or U/L | Parieto-occipital, +/- hippocampus | ++ | − | +/− | +/− basal ganglia, splenium |
Hyperammonaemia | B/L, symmetric | Insula, cingulate gyrus | ++ | − | − | − |
Cerebritis | U/L, localised | Temporal, frontal | ++ | +/− | + | Sinusitis/mastoiditis |
Herpes | Initially U/L, progresses to asymmetric B/L | Orbitofrontal, mesiotemporal, insula | ++ | + | ++ | Leptomeningeal enhancement |
CJD | Diffuse, symmetric/asymmetric | Insula, cingulate gyrus, superior frontal gyrus | + | − | − | Pulvinar |
MELAS | U/L, migratory, waxing-waning | Parietal, temporal, occipital | ++ | +/− | +/− | − |