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Journal of Neuro-Ophthalmology:
doi: 10.1097/WNO.0b013e318294a4b0
Original Contribution

Fatal Ischemic Stroke Complicating Acute Multifocal Placoid Pigment Epitheliopathy: Histopathological Findings

Tsang, Benjamin K.-T. MBBS, BPharm; Chauhan, Devinder S. MBBS, MD, FRCOphth, FRANZCO; Haward, Rebecca MBBS; Whiteman, Ida MBBS; Frayne, Judith MBBS, FRACP; McLean, Catriona BSc, MBBS, FRCPA, MD

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Abstract

A previously healthy 29-year-old man was admitted to a tertiary referral center with acute left hemiparesis followed shortly by de novo convulsive status epilepticus. This was in the context of a 2-month history of flu-like symptoms, severe headaches, and retinopathy recently diagnosed as acute multifocal placoid pigment epitheliopathy. Neuroimaging demonstrated bilateral, multiple territory cerebral infarction. Despite intravenous methylprednisolone and craniotomy for the management of raised intracranial pressure, the patient deteriorated and died 14 days later. At autopsy, multiple infarcts of varying ages within a 10-day period were seen in association with a segmental giant cell vasculopathy of meningeal arteries.

Copyright © 2013 by North American Neuro-Ophthalmology Society

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