A case of multiple non-haemorrhagic infarction in a patient on steroids for immune thrombocytopenic purpura

A 46-year-old male patient with a medical history of diabetes mellitus was diagnosed as ITP based on low platelet counts of 4 x 109/L. While being on oral prednisolone therapy, patient developed seizures and heavy speech. Imaging studies showed multiple small acute established non-haemorrhagic infarction in the left frontal and temporal regions. Patient was treated initially with aspirin 300 mg and subsequently continued on 80 mg aspirin daily for acute ischemic stroke. Further workup did not reveal any clear aetiology for the multiple non-haemorrhagic infarction. Patient had a short stay in ICU and was later transferred to the medical ward. Patient was thought to have had a complex partial seizure with secondary generalization secondary to hyperacute stroke. Etiology of stroke was thought to be most likely due to prothrombotic state.