Unilateral sudden sensorineural hearing loss due to an infarct in the vertebrobasilar system has been widely reported. Most patients have a background of traditional coronary risk factors related to these cerebrovascular episodes.

A 32-year-old male, a regular user of anabolic steroids, presented to the emergency department with unilateral sensorineural hearing loss and symptoms suggestive of an infarct of the anterior inferior cerebellar artery but in the absence of risk factors for ischaemic stroke.

Magnetic resonance imaging confirmed the presence of infarction in the region supplied by the anterior inferior cerebellar artery. Polycythaemia was found on haematological analysis, which we believe was secondary to the use of anabolic steroids. The patient was commenced on aspirin as per the stroke management protocol. There was resolution of neurological symptomatology six weeks after the episode, but no improvement in hearing.

To our knowledge, this is the first case report of unilateral sensorineural hearing loss secondary to the use of anabolic steroids causing polycythaemia. This cause should be considered in the differential diagnosis of patients presenting with sensorineural hearing loss, especially in young males, when no other risk factors can be identified.

Anabolic steroid abuse by women is associated with a number of adverse effects, including laryngeal changes. The epidermal growth factor receptor is related to regulation of the cell life cycle. This study aimed to investigate the structural changes and immunohistochemical localisation of epidermal growth factor receptor in rat vocal folds following anabolic steroid administration, and also to assess the effect of anti-androgens.

Thirty-two adult female albino rats were divided into: group I (controls), group II (receiving anabolic steroids for two months) or group III (receiving anabolic steroids plus anti-androgen for two months).

Group II rat true vocal folds showed thicker epithelial layers with many mitotic figures, thicker lamina propria and thicker muscle fibres; epithelial cells were also immunohistochemically positive for epidermal growth factor receptor. Group III rats showed similar changes, but thin muscle fibres and extravasated red blood cells within the lamina propria.

Anabolic steroids caused structural and immunohistochemical changes within the female rat true vocal fold. Co-administration of anti-androgens did not prevent these changes, suggesting that anti-androgens have a limited role in the management of such changes in humans.