Cerebral cortical restricted diffusion

Last revised by Ryan Thibodeau on 19 Oct 2023

Cerebral cortical restricted diffusion or gyriform restricted diffusion refers to curvilinear hyperintense signal involving the cerebral cortex on DWI images with a corresponding low signal on ADC images.

Causes include the following disorders:

Vascular thrombo-occlusive disease (most common) 1
Hemodynamic changes
Infections
Metabolic 
Others

An acronym has been proposed to cover most of these disorders, which is "CRUMPLED" (Creutzfeldt-Jakob, Reversible cerebral vasoconstriction syndrome, Urea cycle disorders, Mitochondrial, Posterior reversible encephalopathy, Prolonged seizures, Laminar necrosis/hypoxic-ischemic encephalopathy, Liver Disease, Encephalitis, and Diabetes) 5.

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Case 1: cortical venous thombosis
    Drag here to reorder.
  • Case 2: rabies encephalitis
    Drag here to reorder.
  • Case 3: Creutzfeldt-Jakob disease
    Drag here to reorder.
  • Case 4 : postictal changes
    Drag here to reorder.
  • Case 5: hepatic encephalopathy
    Drag here to reorder.
  • Case 6: hypoglycemic encephalopathy
    Drag here to reorder.
  • Case 7: hypoxic-ischemic encephalopathy
    Drag here to reorder.
  • Case 8: methotrexate toxicity
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.