A Young Adult With Internal Carotid Artery Occlusion During Finasteride Therapy: Pathological Findings From a Thrombus Retrieved by Mechanical Thrombectomy

    January 2026 in “ Rinsho Shinkeigaku
    Noriaki Tashiro, Masahiro Yasaka, Takashi Fujii, Kosuke Takigawa, Yoshihiro Fukui, Shuta Maehara
    From the encyclopedia
    Finasteride →

    Frontline, gold standard treatment for combatting androgenic alopecia

    Minoxidil →

    An essential vasodilator with some anti-androgenic effects

    Studysummary In this case study, a 40-year-old male on finasteride and minoxidil for hair loss developed a stroke due to carotid artery blockage, with potential drug interactions impacting coagulation and blood pressure posited as contributing factors.
    Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer
    A 40-year-old man undergoing treatment for male pattern baldness with finasteride (1 mg/day) and minoxidil (10 mg/day) experienced a stroke due to left internal carotid artery occlusion, despite having no apparent risk factors. A dark red thrombus, primarily composed of red blood cells and fibrin, was retrieved through mechanical thrombectomy. This case is a rare report where the thrombus was pathologically evaluated while the patient was on both medications. It is suggested that finasteride may enhance coagulation through estrogen dominance due to androgen suppression, while minoxidil might contribute to the condition by lowering blood pressure. Similar cases of stroke during the use of these medications have been reported in Japan, and this report includes pathological and literature-based considerations.
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