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Table 1 Pattern-based approach to GRD

From: Gyriform restricted diffusion in adults: looking beyond thrombo-occlusions

AetiologyPatternCortical predilectionT2 signalGRE susceptibilityPGEOther involvement
HIEB/L, symmetricPerirolandic, occipital cortex++/−Basal ganglia, thalami, cerebellum
Post-ictalU/L or B/L, diffused or localisedAny lobe, +/− hippocampus+++/−+/− Splenium
HypoglycaemiaB/L, symmetric > asymmetric or U/LParieto-occipital, +/- hippocampus+++/−+/− basal ganglia, splenium
HyperammonaemiaB/L, symmetricInsula, cingulate gyrus++
CerebritisU/L, localisedTemporal, frontal+++/−+Sinusitis/mastoiditis
HerpesInitially U/L, progresses to asymmetric B/LOrbitofrontal, mesiotemporal, insula+++++Leptomeningeal enhancement
CJDDiffuse, symmetric/asymmetricInsula, cingulate gyrus, superior frontal gyrus+Pulvinar
MELASU/L, migratory, waxing-waningParietal, temporal, occipital+++/−+/−
  1. GRE gradient echo sequence, PGE post-gadolinium enhancement