Abstract WP047: Incidental Cerebral Aneurysms in Patients with Cervical Artery Dissection

Background: Patients with cervical artery dissection (CAD) have a higher prevalence of cerebral aneurysms, likely due to underlying vasculopathies. Understanding risk factors and outcomes in this population may inform screening and management strategies. Methods: We conducted a post-hoc analysis of the STOP-CAD study, a multicenter international registry of patients with non-major trauma-related CAD across 63 centers. Cerebral aneurysms were identified based on medical history and intracranial vascular imaging obtained for dissection diagnosis. We compared demographic, clinical, laboratory, and imaging characteristics between patients with and without aneurysms. Variables with p<0.05 in univariate analysis were entered into a multivariable binary logistic regression to identify independent predictors. Clinical outcomes including ischemic stroke and symptomatic intracranial hemorrhage at follow-up were compared between both groups. Results: Out of 4023 patients included in the STOP-CAD study, 116 (2.9%) had at least one incidental cerebral aneurysm. In adjusted binary logistic regression, patients with cerebral aneurysm were more likely to have a history of migraine (aOR 1.78 95% CI 1.15-2.75, p=0.009), history of hypertension (aOR 1.65 95% CI 1.12-2.43, p = 0.010), known connective tissue disorder (aOR 3.47 95% CI 1.71-7.03), history of dissection (aOR 2.63 95% CI 1.31-5.28, p = 0.007), and a dissecting aneurysm at the site of the dissection (aOR 1.94 95% CI 1.25-3.01, p = 0.003). At follow-up, the presence of a cerebral aneurysm was not associated with ischemic stroke (7.8% vs. 5.6% p>0.1), but with a trend towards increased odds of symptomatic intracranial hemorrhage (3.4% vs. 1.2%, p = 0.062). Conclusions: Patients with CAD and concurrent incidental cerebral aneurysm were more likely to have a history of migraine headaches and markers of underlying vasculopathy and had a non-significantly increased risk of intracranial hemorrhage at follow-up. Further studies are needed to identify best practices for surveillance and risk stratification in this subgroup.

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Journal
Stroke
Published
2026-01-29
DOI
https://doi.org/10.1161/str.57.suppl_1.wp047
Primary Topic
Intracranial Aneurysms: Treatment and Complications
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article
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article

Abstract WP047: Incidental Cerebral Aneurysms in Patients with Cervical Artery Dissection

Marcel Arnold, Vishnu Dantu, Setareh Salehi Omran, Adeel Zubair et al.
Stroke
Intracranial Aneurysms: Treatment and Complications
article

Abstract WP047: Incidental Cerebral Aneurysms in Patients with Cervical Artery Dissection

Marcel Arnold, Vishnu Dantu, Setareh Salehi Omran, Adeel Zubair, Marwa Elnazeir, T Kass-Hout, Liqi Shu, Faddi Saleh Velez, Ana Catarina Fonseca, Sofia Vasilopoulou, Brian MacGrory, Richard Choi, Fahad Khan, Mirjam R. Heldner, Mohammed Sarvath, D Liebeskind, Muhib Khan, Diana Aguiar de Sousa, Marialuisa Zedde, João André Sousa, Michele Romoli, Ahmad Nehme, Daniel M Mandel, Stefan T Engelter, Malik Ghannam, Cheran Elangovan, Marc Rodrigo-Gisbert, Ekaterina Bakradze, Joao Pedro Marto, Karen Furie, Sheila Martins, Venugopalan Vishnu, Aaron Rothstein, Ronen Leker, Sami Al Kasab, Thanh N. Nguyen, Alexandre Poppe, Zafer Keser, Shadi Yaghi, Piers Klein, Edgar A. Samaniego, Christoph Stretz, Marina Mannino, Abid Qureshi, Sridhara Yaddanapudi, Christopher Leon Guerrero, Shayak Sen
article en

Abstract

Background: Patients with cervical artery dissection (CAD) have a higher prevalence of cerebral aneurysms, likely due to underlying vasculopathies. Understanding risk factors and outcomes in this population may inform screening and management strategies. Methods: We conducted a post-hoc analysis of the STOP-CAD study, a multicenter international registry of patients with non-major trauma-related CAD across 63 centers. Cerebral aneurysms were identified based on medical history and intracranial vascular imaging obtained for dissection diagnosis. We compared demographic, clinical, laboratory, and imaging characteristics between patients with and without aneurysms. Variables with p<0.05 in univariate analysis were entered into a multivariable binary logistic regression to identify independent predictors. Clinical outcomes including ischemic stroke and symptomatic intracranial hemorrhage at follow-up were compared between both groups. Results: Out of 4023 patients included in the STOP-CAD study, 116 (2.9%) had at least one incidental cerebral aneurysm. In adjusted binary logistic regression, patients with cerebral aneurysm were more likely to have a history of migraine (aOR 1.78 95% CI 1.15-2.75, p=0.009), history of hypertension (aOR 1.65 95% CI 1.12-2.43, p = 0.010), known connective tissue disorder (aOR 3.47 95% CI 1.71-7.03), history of dissection (aOR 2.63 95% CI 1.31-5.28, p = 0.007), and a dissecting aneurysm at the site of the dissection (aOR 1.94 95% CI 1.25-3.01, p = 0.003). At follow-up, the presence of a cerebral aneurysm was not associated with ischemic stroke (7.8% vs. 5.6% p>0.1), but with a trend towards increased odds of symptomatic intracranial hemorrhage (3.4% vs. 1.2%, p = 0.062). Conclusions: Patients with CAD and concurrent incidental cerebral aneurysm were more likely to have a history of migraine headaches and markers of underlying vasculopathy and had a non-significantly increased risk of intracranial hemorrhage at follow-up. Further studies are needed to identify best practices for surveillance and risk stratification in this subgroup.

StrokeVol. 57(Suppl_1)
Boston University (US), West Virginia University (US), University of Iowa (US), University of Maryland, Baltimore (US), Cedars-Sinai Medical Center (US), All India Institute of Medical Sciences Raipur (IN), Brooklyn Hospital Center (US), Barrow Neurological Institute (US), Mayo Clinic (US), University of British Columbia (CA), University of Louisville (US), Medical University of South Carolina (US), University of Bridgeport (US), University of Tennessee Health Science Center (US), Duke University (US), University of Basel (CH), National and Kapodistrian University of Athens (GR), Brown University (US), UCLA Health (US), Hadassah Medical Center (IL), University Hospital of Bern (CH), Carolinas Medical Center (US), University of Alabama at Birmingham (US), Yale University (US), University of Chicago (US), Azienda Sanitaria Unità Locale di Reggio Emilia (IT), United Hospital Center (US), Unidade Local de Saúde de São José (PT), Hospital de Clínicas de Porto Alegre (BR), Ospedale Vincenzo Cervello (IT), Hospital de Egas Moniz (PT), All India Institute of Medical Sciences Bhopal (IN), Ospedale “M. Bufalini” di Cesena (IT), Centre Hospitalier Universitaire de Caen Normandie (FR), Vall d'Hebron Hospital Universitari (ES), University of Kansas Medical Center (US), Frontier Science Foundation-Hellas (GR), Centre Hospitalier de l’Université de Montréal (CA), Hackensack Meridian Health (US), Hospital de Santa Maria (PT), New York University Langone Orthopedic Hospital (US), All India Institute of Medical Sciences (IN), University of Coimbra (PT), University of Pennsylvania (US), University of Delaware (US), University of Oklahoma (US), University of Colorado Denver (US), Université de Caen Normandie (FR)
Openalex Percentile: Top 76%
Intracranial Aneurysms: Treatment and Complications
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