Sudden death due to undiagnosed medullary-pontine astrocytoma

A 20-year-old woman died suddenly and unexpectedly from low-grade medullary pontine fibrillary astrocytoma. She had experienced neurological symptoms including coughing and choking thought to be asthma, poor motor coordination, nasopharyngeal incompetence, and arm pain since the age of 11 months. Despite the long history of symptoms, the tumor remained clinically undiagnosed. This case demonstrates the minor, nonlocalizing, and relapsing remitting nature of symptoms and signs related to this slow-growing tumor. To the best of our knowledge, this is the first case of sudden, unexpected death due to brainstem glioma in the English-language literature. Since autopsy disclosed a 5-7 week pregnancy, this case is also an example of a rare cause of maternal death.