Adults with cervical artery dissection who develop dissecting aneurysms do not face increased stroke risk compared to those without aneurysms during the first six months after diagnosis, according to a preliminary study analysis from a global registry. The findings provide crucial clinical guidance for managing this condition that accounts for up to 25% of strokes in adults under 50.
Cervical artery dissection causes approximately 2% of ischemic strokes overall but represents a significant proportion of strokes in younger adults. The condition involves a tear in the inner wall of a neck artery, which can allow blood to leak and form clots that may travel to the brain. In some cases, this leakage creates a bulge called a dissecting aneurysm. Researchers analyzed data from the STOP-CAD study, a multicenter international registry, to better understand this complication.
The analysis of 4,008 adults with cervical artery dissection revealed that about 19% developed dissecting aneurysms. Importantly, these patients showed no higher stroke risk than those without aneurysms during the six-month follow-up period. Among those with aneurysms, approximately 10% showed aneurysm growth over six months, but this growth also did not correlate with increased stroke risk.
"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 author Muhib Khan, M.D., M.B.B.S., of Mayo Clinic. The research team leveraged the large STOP-CAD dataset to provide comprehensive insights into diagnosis, monitoring, and outcomes.
The study identified that patients with dissecting aneurysms were more likely to have histories of migraines, connective tissue disorders, and minor neck trauma before dissection. These risk factors may help clinicians monitor for aneurysm development. "Reassuringly, dissecting aneurysm formation was not related to hemorrhagic stroke or increased mortality either," noted co-author Zafer Keser, M.D., also of Mayo Clinic.
These findings could significantly impact clinical practice by potentially reducing unnecessary interventions and frequent imaging. Former International Stroke Conference chair Louise D. McCullough, M.D., Ph.D., FAHA, who was not involved in the study, explained that the 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."
The study has limitations, including its retrospective design and reliance on image reviews without standardized centralized assessment processes. Researchers noted that a prospective study following patients over time with clearly outlined treatment methods would help confirm these preliminary findings. The research will be presented at the American Stroke Association International Stroke Conference 2026 in New Orleans.
Stroke remains a significant health concern, ranking as the fourth leading cause of death in the United States according to the American Heart Association's 2026 Heart Disease and Stroke Statistics. The American Stroke Association provides additional resources through their Stroke Hub and educational materials. While these findings offer important clinical guidance, researchers emphasize that the study is preliminary until published in a peer-reviewed journal.
