Ischemic Stroke in the Setting of Anabolic Androgenic Steroid Use.

INTRODUCTION Stroke occurs in approximately 795,000 people in the United States every year, with 87% being ischemic.1 Age is an important risk factor for stroke,2 with 62% of stroke patients being ≥ 65 years old, with a 13% 30-day mortality in patients ≥ 85 years old.3 Stroke risk consisted of 87% of important modifiable risk factors and included hypertension, obesity, hyperglycemia, hyperlipidemia, diabetes mellitus, and renal dysfunction.2 Behavioral risk factors included 47% of risk and included smoking, physical inactivity, and diet. While there were overlaps in risk factors for older adults, risk factors for young adults (≤ 50 years old) also included migraine, hormonal contraceptives, and pregnancy, along with other known etiologies such as cervical arterial dissection, vasculitis, hematologic diseases, and substance abuse.4 Anabolic androgenic steroid (AAS) abuse is used for enhancement of athletic performance, physical appearance, and sexual function.5 Adverse effects of AAS usage include secretion suppression of gonadotropins, neuropsychiatric effects, dyslipidemia, hypertension, arrhythmia, erythrocytosis,5 and decreased arterial plasticity.6 This report summarizes an instance of ischemic stroke in a young male who reported using both stanozolol and clenbuterol in preparation for a bodybuilding contest. Written, informed consent was obtained for the publication of this report.