[CLIPPERS syndrome - a disorder with many faces- a case report]. / CLIPPERS-Syndrom: Eine Erkrankung mit vielen Gesichtern ­ ein Fallbericht.

The CLIPPERS syndrome is a chronic, inflammatory disorder of the central nervous system of unknown etiology, which was first described in 2010 by Pittock and colleagues. It is characterized by typical magnetic resonance imaging (MRI) changes with lesions mainly in the brainstem, a perivascular, lymphohistiocytic inflammatory process and significant improvement under glucocorticoid therapy. Here we describe the case of a 40-year-old male who presented initially with typical clinical and radiological signs of CLIPPERS syndrome and who achieved complete remission under immunosuppressive therapy. Two years later, he presented with severe headaches. The MRI showed a reappearance of the lesion in the cerebellum, but now with a confluent character. The first brain biopsy showed lymphoproliferation. A second brain biopsy could finally confirm the suspected diagnosis of a primary CNS lymphoma.

Epidural venous thrombosis as differential diagnosis in back pain patients.

Epidural venous thrombosis is a rare clinical entity with a characteristic constellation of findings in contrast-enhanced MRI, which should be considered in the differential diagnosis in the case of clinical symptoms that are initially indicative of disc herniation. The most important distinctive feature between epidural venous thrombosis and disc herniation is their topographical location in relation to the vertebral venous plexus. Particularly where morphological imaging shows a space-occupying lesion in close proximity to the internal vertebral venous plexus and a central contrast medium defect, epidural venous thrombosis should be taken into consideration.