People who develop an aneurysm alongside a cervical artery dissection, which is a tear in the inner lining of a neck artery and a known cause of stroke especially among younger adults, may not face an increased risk of stroke within six months after diagnosis. This finding comes from a preliminary study that will be presented at the American Stroke Association's International Stroke Conference 2026, scheduled for February 4-6 in New Orleans.
Cervical artery dissection (CeAD) is responsible for about 2% of all ischemic strokes but accounts for up to 25% of strokes in adults under age 50. The condition occurs when there is a tear in the inner wall of an artery in the neck, which can allow blood to leak out and form a clot that might travel and cause a stroke. Sometimes, this process creates a bulge or balloon in the artery known as a dissecting aneurysm.
Researchers conducted their analysis using data from the Antithrombotics for Stroke Prevention in Cervical Artery Dissection (STOP-CAD) study, which is multicenter and international. They separated CeAD patients based on whether they had dissecting aneurysms and examined if these aneurysms were growing or associated with specific factors.
"Reassuringly, dissecting aneurysm formation was not related to hemorrhagic stroke or increased mortality either," said study co-author Zafer Keser, M.D., associate professor of neurology at Mayo Clinic in Rochester, Minnesota. "Our study provides important information to help health care professionals better monitor and manage patients during the first six months after diagnosis of an aneurysm."
The researchers noted limitations including reliance on image reviews by radiologists and neurologists without standardized processes for assessing patient outcomes during initial months post-diagnosis. The retrospective nature of their analysis also means it looked back at existing health records rather than following patients over time. They suggested that future studies should follow patients prospectively over longer periods with clear treatment protocols to confirm these results.
"The study adds to existing evidence that suggests cervical artery dissections have a low risk of recurrent stroke," said Louise D. McCullough, M.D., Ph.D., FAHA, former chair of the International Stroke Conference. "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 that 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," added McCullough, who serves as Roy M. and Phyllis Gough Huffington Distinguished Chair of Neurology at McGovern Medical School; chief of neurology at Memorial Hermann Hospital-Texas Medical Center; and co-director at UTHealth Neurosciences in Houston. She was not involved in this research.
