Abstract
Abstract A132: Young Adults with Cervical Artery Dissection have a Distinct Clinical Phenotype: A Post-Hoc Analysis of the STOP-CAD Study
Stroke (1970), Vol.57(Suppl_1)
02/2026
DOI: 10.1161/str.57.suppl_1.A132
Abstract
Background and Objectives: Cervical artery dissection (CeAD) is a common cause of ischemic stroke in young adults. We aim to identify age-based differences in clinical presentation, imaging findings, and outcomes after CeAD.
Methods: This was a sub-study using the STOP-CAD registry, a multicenter cross-sectional international retrospective study of patients diagnosed with CeAD and treated with an antithrombotic from January 1, 2015 to December 31, 2021. Baseline clinical and imaging characteristics were compared between younger and older adults with CeAD (≤45 versus >45 years of age) using multivariable logistic regression. We chose this age cut off due to its frequent usage in stroke in the young literature. Multiple logistic regression models were used to determine association between young age and outcomes after CeAD (ischemic stroke at 180 days, excellent functional outcome with modified Rankin Scale of 0-1 at 90 days, and mortality) after adjusting for sex, vascular risk factors, CeAD characteristics, and NIHSS on presentation.
Results: Among 4023 CeAD patients included in the study, 1901 (47.3%) were ≤45 years of age. Patients were followed for a median of 307 days (IQR 102-831). Young adults with CeAD were more likely to be women (Odds Ratio [OR], 2.4; 95% CI, 2.1-2.9; p<0.001), of Hispanic ethnicity (OR, 1.8; 95% CI 1.3-2.5; p<0.001), have a history of migraines (OR, 1.6; 95% CI, 1.3-2.0; p<0.001) and recent neck trauma (OR, 1.6; 95% CI, 1.3-1.9; p<0.001) while having fewer traditional vascular risk factors. Young adults with CeAD had higher odds of a non-ischemic presentation (OR, 1.3; 95% CI, 1.1-1.5; p=0.013), vertebral artery dissection (OR 2.5; 95% CI, 2.2-3.0; p<0.001), and multivessel involvement (OR 1.5; 95% CI, 1.1-1.9; p=0.004). In adjusted analysis, younger age was not associated with an increased risk of recurrent ischemic stroke (adjusted Hazard Ratio [HR], 0.48; 95% CI 0.2-1.2; p=0.119). Younger age was associated with significantly greater odds of excellent functional outcome at 90 days (aOR, 1.48; 1.20-1.84, p<0.001) and lower risk of death at follow up (aHR, 0.37; 95% CI, 0.17-0.81; p=0.012) after CeAD.
Conclusion: In a large international cohort, young adults with CeAD had a distinct clinical phenotype with higher odds of non-ischemic presentation, vertebral artery dissection, and multivessel involvement while having fewer traditional vascular risk factors. Young adults had a decreased odds of disability and mortality after CeAD.
Details
- Title: Subtitle
- Abstract A132: Young Adults with Cervical Artery Dissection have a Distinct Clinical Phenotype: A Post-Hoc Analysis of the STOP-CAD Study
- Creators
- Setareh Salehi Omran - University of Colorado DenverLiqi Shu - Brown UniversityShadi Yaghi - Brown UniversityChristian Sidebottom - University of Tennessee Health Science CenterRoss Crandall - University of Colorado DenverEvan Lester - University of Colorado DenverConner Lee - Bowdoin CollegeNils Henninger - University of Massachusetts Chan Medical SchoolJayachandra Muppa - University of Massachusetts Chan Medical SchoolMuhammed Gunduz - University of Massachusetts Chan Medical SchoolMirjam Heldner - University Hospital of BernKateryna Antonenko - University Hospital of BernAhmad Nehme - Normandie UniversitéMuhib Khan - Mayo ClinicDania Mallick - Rhode Island HospitalAaron Rothstein - University of PennsylvaniaOssama Khazaal - Temple University HospitalJosefin Emelie Kaufmann - University Hospital of BaselStefan Engelter - University of BaselChristopher Traenka - Univers. Altersmedizin Felixplatter, Basel, SwitzerlandPreet Gandhi - University of British ColumbiaIssa Metanis - Hadassah Medical CenterRonen Leker - Hadassah Medical CenterRegina von Rennenberg - Humboldt-Universität zu BerlinReza Bavarsad Shahripour - University of California San DiegoXiaofan Guo - UPMC, Pittsburgh, Pennsylvania, United StatesMalik Ghannam - University of IowaMohammad AlMajali - Ochsner Medical CenterEdgar Samaniego - University of IowaAna Fonseca - Hospital de Santa MariaDiana Cruz - Hospital de Santa MariaMichele Romoli - Ospedale “M. Bufalini” di CesenaZafer Keser - Mayo ClinicMarialuisa Zedde - Azienda Sanitaria Unità Locale di Reggio EmiliaBrian Mac Grory - Duke UniversityEkaterina Bakradze - University of Alabama at BirminghamFaddi Saleh Velez - University of OklahomaMary Penckofer - Cooper University Health CareJames Siegler - University of ChicagoJoshua Willey - Columbia UniversityAdeel Zubair - Yale UniversityJoao Pedro Marto - Hospital de Egas MonizPiers Klein - Boston Medical CenterThanh Nguyen - Boston Medical CenterFarid Khasiyev - Columbia University Irving Medical CenterAlexis Simpkins - Cedars-Sinai Medical CenterMarwa Elnazeir - University of LouisvilleBalaji Krishnaiah - University of Tennessee at KnoxvilleCheran Elangovan - University of Tennessee Health Science Center
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.57(Suppl_1)
- DOI
- 10.1161/str.57.suppl_1.A132
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Publisher
- Lippincott Williams & Wilkins
- Language
- English
- Date published
- 02/2026
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9985132083602771
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