Anabolic Androgenic Steroids and Stroke

Anabolic androgenic steroids (AAS) are synthetic substances derived from testosterone and usually employed to gain muscle strength and athletic performance. Supraphysiological doses of AAS can cause harmful conditions such as cardiovascular, hematological, hepatic, and psychiatric disorders. Among their cardiovascular effects, heart disease and sudden death have been frequently described. Furthermore, several cases of stroke in young patients possibly related to the consumption of these hormones have been reported. AAS may contribute to the onset of a stroke through direct cardiac effects and indirect prothrombotic and proatherogenic mechanisms. In professional sports, AAS consumption is regulated by international agencies and affects a relatively small population. However, the major use of these substances in our society is currently made by many young bodybuilding enthusiasts in gyms, without adequate regulation and sanitary control. Owing to the illegal nature of their consumption, stroke related to anabolic steroids is probably underdiagnosed. Thus, we recommend performing a straight anamnesis toward a possible covert use of these substances, especially in young patients with cryptogenic stroke.