Anabolic Androgen Abuse-Associated Cerebral Venous Sinus Thrombosis in a Young Adult: A Case Report.

Cerebral venous sinus thrombosis (CVST) is a rare and potentially life-threatening cause of stroke that predominantly affects young adults and often presents with nonspecific symptoms, leading to diagnostic delay. We report the case of a 29-year-old man with no prior medical comorbidities who presented with a progressively worsening headache and new-onset generalized tonic-clonic seizure. Detailed history revealed long-term abuse of anabolic androgenic steroids for bodybuilding purposes. Clinical examination demonstrated papilledema, and laboratory investigations were notable for secondary polycythemia, while an extensive thrombophilia workup was unremarkable. Neuroimaging with computed tomography and magnetic resonance venography confirmed thrombosis of the superior sagittal and right transverse sinuses with associated venous infarction. The patient was managed with therapeutic anticoagulation, antiepileptic therapy, and measures to control intracranial pressure, alongside immediate cessation of androgen use. His clinical course was favorable, with symptomatic improvement, partial radiological recanalization, and complete neurological recovery at follow-up. This case highlights androgen abuse as a rare but important reversible risk factor for CVST and underscores the importance of thorough substance use history taking, early diagnosis, and prompt anticoagulation to optimize outcomes.