Delayed diagnosis of a cerebrovascular accident associated with anabolic steroid use

Abstract

The authors report a case of atherosclerotic stroke in a 46-year-old recreational bodybuilder with a 20 year history of anabolic-adrenergic steroid (AAS) abuse. Cerebrovascular accident (CVA) occurred during his third week of hospital admission for an acute abdomen and on day 8, postemergency laparotomy. CVA presented with collapse, generalised seizures, reduced Glasgow Coma Score and severe hypertension. He was subsequently admitted to the intensive care unit (ICU), where initial investigations did not illustrate an underlying diagnosis. By day 4 in ICU, there had been no significant clinical improvement and radiological investigations were repeated, identifying a left frontal lobe infarct in the middle cerebral artery territory. The authors propose CVA was secondary to AAS. After a prolonged and complicated period of rehabilitation, he has been discharged home; he requires carers due to dyspraxia and is mobilising independently.

Anabolic androgenic steroid abuse in the United Kingdom: An update

“…Damage to the cardiovascular system may also remain masked and may not manifest to a significant degree until later in life (Reza, Ågren, & Thiblin, ), although there is mounting evidence to link anabolic androgenic steroid‐associated cardiovascular damage and thrombosis with cerebrovascular accident in younger anabolic androgenic steroid users (Cooper, Reeve, & Doherty, ; Shimada et al, ; Youssef, Alqallaf, & Abdella, ). Accounts of alterations and effects on the cardiovascular system are somewhat inconsistent.…”