A Young Male with Hemorrhagic Cerebral Infarction Associated with Finasteride and Minoxidil

This case report discusses a 21-year-old man who experienced a hemorrhagic cerebral infarction, a type of stroke, while taking finasteride and minoxidil, medications commonly used for androgenetic alopecia (male pattern baldness) and weight training. The young man noticed a headache and visual field abnormality during a weight training session. Despite a thorough investigation, the source of the embolism that caused the stroke was unclear, raising suspicion of a connection with the drugs he was taking. Imaging scans revealed the stroke in the right occipital lobe of his brain, but no other clear abnormalities. The patient's laboratory findings were mostly normal, although a slight increase in D-dimer, a blood test that can help detect blood clot formation, was observed. According to the report, there have been multiple instances of cerebral infarctions associated with the use of finasteride reported in the PMDA's pharmaceuticals and medical devices database. However, the causal relationship between minoxidil use and cerebral infarction has not been established. The study emphasizes the importance of obtaining a detailed medical history, including the use of unlicensed drugs, if an infarction occurs. This case report also includes a discussion on the possible pathophysiological mechanism that might have led to cerebral infarction in this instance.