An Unusual Case of Thalamic Stroke in a Young Adult With Patent Foramen Ovale and Finasteride Use

A 21-year-old male with no cerebrovascular risk factors experienced a thalamic stroke, which was linked to a patent foramen ovale (PFO) and finasteride use. Finasteride, used for male pattern baldness, can elevate testosterone levels and increase thrombosis risk. The patient showed neurological deficits and imaging confirmed a left thalamic infarct. PFO closure led to symptomatic improvement, and discontinuation of finasteride was recommended to reduce thrombotic risk. This case highlights the importance of evaluating PFO and hypercoagulable states in young stroke patients and suggests that stopping finasteride may help prevent thrombosis.