Adults with a dissecting aneurysm accompanying cervical artery dissection showed no increased risk of stroke compared to those with cervical artery dissection alone during the first six months after diagnosis, 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 much-needed clinical guidance for managing this condition that accounts for up to 25% of strokes in adults under 50.
Cervical artery dissection occurs when a tear develops in the inner wall of a neck artery, potentially allowing blood to leak and form clots that can lead to stroke. In some cases, this leakage creates a bulge called a dissecting aneurysm. Researchers analyzed data from the Stroke Prevention in Cervical Artery Dissection (STOP-CAD) Multicenter Global Registry, which enrolled 4,008 patients from 63 sites across 16 countries between 2010 and 2023. Approximately 19% of participants developed a dissecting aneurysm.
The analysis revealed that people with dissecting aneurysms were more likely to have a history of migraines, connective tissue disorders, and minor neck trauma prior to dissection. These factors may help clinicians monitor for aneurysm development. Importantly, the presence of a dissecting aneurysm did not correlate with higher stroke risk, and even aneurysm growth observed in about 10% of cases did not increase stroke likelihood. Study co-author Zafer Keser noted that dissecting aneurysm formation was also not related to hemorrhagic stroke or increased mortality.
"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. The research leveraged the large STOP-CAD dataset to provide a comprehensive overview of dissecting aneurysm diagnosis, monitoring, and outcomes. Additional information about stroke statistics and resources can be found at https://www.stroke.org and through the American Heart Association's health information on https://www.heart.org.
Louise D. McCullough, former chair of the International Stroke Conference, commented that the findings add to evidence suggesting cervical artery dissections have low recurrent stroke risk. "Having a dissecting aneurysm may not be as scary as we initially thought," she said. The results could influence clinical practice by potentially reducing the frequency of imaging follow-ups and reconsidering interventions like carotid stent placement, which requires chronic antiplatelet therapy.
The study has limitations, including its retrospective design and reliance on image reviews without standardized centralized assessment. Researchers noted that a prospective year-long study with clearly outlined treatment methods would help confirm the findings. The abstract detailing these results, Abstract A048: De Novo Pseudoaneurysm Formation After Cervical Artery Dissection: Incidence, Risk Factors, and Outcomes, is part of the American Stroke Association International Stroke Conference 2026 program. The study authors emphasize that these preliminary findings require confirmation through peer-reviewed publication.
