Findings
- Multiple nonexpansile areas of T2/FLAIR signal hyperintensity involving the pons, right cerebellar white matter and dentate nucleus, left thalamocapsular junction, and high bilateral frontoparietal juxtacortical white matter
- Corresponding patchy enhancement
- No associated restricted diffusion
- No substantial intracranial mass effect
Annotated Images & Illustrations
Relatively symmetric patchy T2 signal hyperintensity and enhancement in the pons (red arrows), which is a typical imaging appearance for CLIPPERS.
Interestingly, this patient later developed hypertrophic olivary degeneration (red arrow) contralateral to their dentate nucleus involvement.
Diagnosis
Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS)
Key Imaging Features
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Differential Diagnosis
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Discussion
Pearls
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