The most systematic way I know to attack this problem is to break the set of all possible such $A$, i.e., $2 \times 2$ matrices with
$A^2 = -I \tag{1}$
into categories according to $\text{Tr}(A)$, the trace of $A$. With
$A = \begin{pmatrix} a & b \\ c & d \end{pmatrix} \tag{2}$
we have
$A^2 = \begin{pmatrix} a^2 + bc & b(a + d) \\ c(a + d) & d^2 + bc \end{pmatrix}, \tag{2}$
as may be easily seen; note that
$\text{Tr}(A) = a + d. \tag{3}$
With
$A^2 = -I \tag{4}$
we have
$a^2 + bc = -1; \tag{5}$
$d^2 + bc = -1; \tag{6}$
$(a + d)b = b\text{Tr}(A) = 0; \tag{7}$
$(a + d)c = c \text{Tr}(A) = 0. \tag{8}$
If
$\text{Tr}(A) \ne 0, \tag{9}$
we see that
$b = c = 0, \tag{10}$
whence
$a^2 = d^2 = -1; \tag{11}$
thus
$a = \pm i \tag{12}$
and
$d = \pm i; \tag{13}$
there are no real solutions; furthermore since $\text{Tr}(A) \ne 0$ we must in fact have $a = d$, thus in this case we may only have
$A = \pm i I. \tag{14}$
The case $\text{Tr}(A) = 0$ yields
$d = -a; \tag{15}$
we can thus choose $a = \alpha \in \Bbb C$ freely and then $d = -\alpha$. (15) implies
$a^2 = d^2 = \alpha^2, \tag{16}$
so that both (5) and (6) become
$\alpha^2 + bc = -1, \tag{17}$
$bc = -1 - \alpha^2; \tag{18}$
in the event $\alpha \ne \pm i$ we can choose
$0 \ne \beta \in \Bbb C \tag{19}$
then set
$b = \beta, \tag{20}$
and find
$c = -\dfrac{1 + \alpha^2}{\beta} \ne 0; \tag{21}$
thus
$A = \begin{pmatrix} \alpha & \beta \\ -\dfrac{1 + \alpha^2}{\beta} & -\alpha \end{pmatrix}, \;\; \alpha, \beta \in \Bbb C, \; \beta \ne 0. \tag{22}$
The case $\alpha = \pm i$ forces
$bc = 0; \tag{23}$
thus, at least one, and perhaps both, of $b, c = 0$. Now $A$ takes either the form
$A = \begin{pmatrix} \pm i & \beta \\ 0 & \mp i \end{pmatrix}, \;\; \beta \in \Bbb C, \tag{24}$
or the transposed form
$A = \begin{pmatrix} \pm i & 0 \\ \beta & \mp i \end{pmatrix}, \;\; \beta \in \Bbb C. \tag{25}$
Of course, if we require real $A$, then (11)-(14) are denied to us; only cases with $\text{Tr}(A) = 0$ are permitted; we can however choose $\alpha \in \Bbb R$ freely as we can $0 \ne \beta \in \Bbb R$; $1 + \alpha^2 \ne 0$ in this case, but $A$ is still given by (22), though (24), (25) are ruled out.
That's the most systematic analysis of this problem I know. The observation that $\text{Tr}(A)$ provides a convenient classification of solutions is perhaps not a surprise in light of the importance of the trace, a similarity invariant, to a general understanding of matrices. (Note that the equation $A^2 = -I$ is in fact preserved under similarity: $(P^{-1}AP)^2 = A^2 = -I$.) However, this line of analysis only works for matrices of size $2$.
A similar analysis of the case $A^2 = I$ may be found in my answer to this question; further commentary may there be found.
Finally, I for one would be very interested in seeing how these techniques carry over to matrices over other fields, such as the $GF(p^n)$ etc.; offhand, it seems as long as we are not in characteristic $2$, many of the arguments will fly.