Adults who develop dissecting aneurysms alongside cervical artery dissection do not face an increased risk of stroke during the first six months after diagnosis compared to those with cervical artery dissection alone, according to a preliminary study analysis from a global registry. The findings, to be presented at the American Stroke Association's International Stroke Conference 2026, provide crucial information for clinicians managing this condition, which is a significant cause of stroke in younger adults.
Cervical artery dissection, a tear in the inner lining of a neck artery wall, accounts for approximately 2% of all ischemic strokes but represents up to 25% of strokes in adults under 50 years old. When blood leaks through such a tear, it can form a clot that may travel to the brain, causing a stroke. In some cases, this leakage creates a bulge or balloon in the artery wall, known as a dissecting aneurysm. Researchers have historically had limited scientific information about dissecting aneurysms, including optimal diagnosis, monitoring, and management strategies.
The study, a subanalysis of the Antithrombotics for Stroke Prevention in Cervical Artery Dissection (STOP-CAD) research, examined data from over 4,000 participants across 63 sites in 16 countries. Researchers found that approximately 19% of cervical artery dissection patients developed dissecting aneurysms. Notably, these patients did not demonstrate a higher stroke risk compared to those without aneurysms during the six-month follow-up period. Furthermore, among the subset with dissecting aneurysms, about 10% showed aneurysm growth over six months, yet this growth also did not correlate with increased stroke risk.
Study author Muhib Khan, M.D., M.B.B.S., an associate professor in neurology at the Mayo Clinic, emphasized the value of leveraging large datasets to provide a comprehensive overview. The analysis identified that individuals with dissecting aneurysms were more likely to have a history of migraines, connective tissue disorders, and minor neck trauma prior to the dissection. These factors may assist clinicians in monitoring for aneurysm development. Co-author Zafer Keser, M.D., also an associate professor at the Mayo Clinic, added that dissecting aneurysm formation was not associated with hemorrhagic stroke or increased mortality, offering further reassurance.
The implications of these findings are significant for clinical practice. According to Louise D. McCullough, M.D., Ph.D., FAHA, former chair of the International Stroke Conference, the results suggest that frequent imaging follow-ups for these patients might be reduced, and invasive interventions like carotid stent placement—which requires chronic antiplatelet therapy—might be reconsidered when the recurrent stroke risk is understood to be low. McCullough, who was not involved in the study, noted that the findings help patients understand that although there is damage to the neck artery, their rate of recurrent stroke remains low.
The study has limitations, including its retrospective design and reliance on image reviews by radiologists and neurologists without a standardized, centralized assessment process. Researchers acknowledge that a prospective, year-long study with clearly outlined treatment methods and image interpretation protocols would help confirm these results. The research abstract is available in the American Stroke Association International Stroke Conference 2026 Online Program Planner.
This analysis contributes to growing evidence that cervical artery dissections carry a low risk of recurrent stroke. For health care professionals and patients, the study offers important guidance for monitoring and management during the critical first six months after diagnosis, potentially reducing unnecessary procedures and anxiety. The American Heart Association provides additional resources on stroke through its Stroke Hub and related educational materials.
