Patients who developed an aneurysm with a cervical artery dissection (CeAD)—particularly young adults—did not experience an increased risk of stroke within the six months after diagnosis in a study from which preliminary data are set to be presented at the upcoming International Stroke Conference (ISC; 4–6 February 2026, New Orleans, USA).
A press release from the American Stroke Association (ASA) notes that CeAD causes about 2% of ischaemic strokes overall, but accounts for up to 25% of strokes in adults younger than 50 years old.
“We have little scientific information about dissecting aneurysm, including how to best diagnose, monitor aneurysm growth and manage the health of people with dissecting aneurysms,” said study co-author Muhib Khan (Mayo Clinic, Rochester, USA). “We leveraged a large dataset from a global registry to provide a comprehensive overview of dissecting aneurysm diagnosis, monitoring and outcomes.”
Khan and colleagues performed a secondary subanalysis of data from the multicentre, international STOP-CAD study, with patients—those diagnosed with CeAD from 2010–2023 at 63 sites across 16 countries and followed for six months post-diagnosis—being stratified for the presence of dissecting aneurysms, and researchers examining data for signs that the aneurysm was growing as well as to identify factors associated with dissecting aneurysm.
These analyses found that dissecting aneurysm is common in people with CeAD and, generally, is not life-threatening in the first six months after diagnosis. Across more than 4,000 participants with CeAD (average age, 46 years; 50% men), about one in five (19%) developed a dissecting aneurysm.
People with a dissecting aneurysm were more likely to have a history of migraines, connective tissue disorders and minor neck trauma before the dissection. According to the researchers, these risk factors may assist clinicians in monitoring for the development of dissecting aneurysms.
However, people with CeAD and dissecting aneurysms did not have a higher risk of stroke compared to those with CeAD but no dissecting aneurysms. And, while about 10% of those who had a dissecting aneurysm saw aneurysm growth over the course of six months, dissecting aneurysm growth did not lead to a higher risk of stroke.
“Reassuringly, dissecting aneurysm formation was not related to haemorrhagic stroke or increased mortality either,” said study co-author Zafer Keser (Mayo Clinic, Rochester, USA). “Our study provides important information to help healthcare professionals better monitor and manage patients during the first six months after diagnosis of an aneurysm.”
A notable limitation of this study was the fact that it relied on the review of medical images by radiologists and trained neurologists without a standardised, centralised process for assessing how patients fared during the initial months after diagnosis. The analysis also had a retrospective design, meaning researchers looked back in time at the health information from the STOP-CAD study. A yearlong study that closely follows patients over time and clearly outlines treatment methods—as well as how researchers interpret the images—would help to confirm these results, Khan, Keser and colleagues acknowledged.
“The study adds to existing evidence that suggests cervical artery dissections have a low risk of recurrent stroke,” said former ISC chair Louise McCullough (UTHealth Neurosciences, Houston, USA), who was not involved in the study. “Having a dissecting aneurysm may not be as scary as we initially thought. It helps us and our patients understand that, although there is damage to the artery of the neck, their rate of recurrent stroke is low—and that’s reassuring.
“The results could have practical implications as well. Often, we follow these patients with a lot of imaging that we may not need to do quite as often. These results will probably give us a little bit of pause if we’re thinking about doing an intervention, such as placing a carotid stent—which would require chronic antiplatelets—if we know the risk of recurrent strokes in patients with dissecting aneurysms is low.”
