Abstract
Abstract WP127: Sex-Specific Differences in Presentation and Outcomes after Cervical Artery Dissection
Stroke (1970), Vol.57(Suppl_1)
02/2026
DOI: 10.1161/str.57.suppl_1.WP127
Abstract
Background and Objectives: Cervical artery dissection (CeAD) is a leading cause of ischemic stroke in younger adults, yet sex-specific variations in its clinical presentation, imaging characteristics, and outcomes remain underexplored. We aimed to evaluate these differences using data from a large, multicenter registry.
Methods: We analyzed data from the STOP-CAD registry, which includes patients with radiologically confirmed non-traumatic CeAD enrolled between 2015 and 2021 across multiple centers. Clinical and imaging characteristics were compared between men and women using multivariable logistic regression. Outcomes assessed included ischemic stroke recurrence at 180 days, excellent functional outcome (modified Rankin Scale [mRS] 0-1) at 90 days, symptomatic intracerebral hemorrhage (sICH), and mortality.
Results: Among 4,023 patients with CeAD, 1,783 (44.6%) were women. Compared to men, women were younger (median age: 42 vs 50 years), more likely to have a history of migraine (26.9% vs 8.3%) and connective tissue disorders (14.3% vs 5.8%), and presented more frequently with non-ischemic symptoms such as headache, neck pain, or tinnitus (adjusted OR [aOR] 2.0; 95% CI, 1.8-2.3; p<0.001). Women had significantly higher odds of vertebral artery dissection (OR, 1.3; 95% CI, 1.2-1.5; p<0.001), multivessel involvement (OR, 2.1; 95% CI, 1.7-2.5; p<0.001), and pseudoaneurysm formation (OR, 1.3; 95% CI, 1.1-1.6; p=0.003). Despite these differences, there was no significant sex-based difference in key clinical outcomes: excellent functional recovery at 90 days (OR 0.94; 95% CI 0.76-1.15 p=0.542), ischemic stroke recurrence at 180 days (OR 0.56 CI 0.23-1.3 p=0.213), or mortality (OR 0.83; 95% CI 0.47-1.48, p=0.529).
Conclusion: In this large international cohort, we observed women with CeAD were younger, more likely to present with non-ischemic symptoms with distinct imaging features. These underscore the need for heightened clinical suspicion of CeAD in women presenting with atypical symptoms, even in the absence of ischemic deficits or conventional vascular risk factors, and suggest that sex-specific phenotyping may enhance diagnostic accuracy and early management.
Details
- Title: Subtitle
- Abstract WP127: Sex-Specific Differences in Presentation and Outcomes after Cervical Artery Dissection
- Creators
- Christian Sidebottom - University of Tennessee Health Science CenterSetareh Salehi Omran - University of Colorado DenverShadi Yaghi - Hackensack Meridian HealthLigi Shu - Brown UniversityConner Lee - Bowdoin CollegeRoss Crandell - University of Colorado DenverEvan Lester - Cornell UniversityNils Henninger - UMass Memorial Medical CenterJayachandra Muppa - University of Massachusetts Chan Medical SchoolMuhammed Gunduz - Yale UniversityMirjam Heldner - University Hospital of BernAntonenko Katheryna - 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 - University of BaselPreet Gandhi - University of British ColumbiaIssa Metanis - Hadassah Medical CenterRonen Leker - Hadassah Medical CenterRegina Von Renneberg - Charité - Universitätsmedizin BerlinReza Bavarsad Shahripour - University of California San DiegoXiaofan Guo - UPMC, Pittsburgh, Pennsylvania, United StatesMalik Ghannam - University of IowaMohammad AlMajali - University of IowaEdgar Samaniego - University of IowaAna Fonseca - Hospital de Santa MariaDiana Cruz - Administração Regional de Saúde de Lisboa e Vale do TejoMichele Romoli - Ospedale “M. Bufalini” di CesenaZafer Keser - Mayo ClinicZedde Marialuisa - 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, Camden, New Jersey, United StatesJames Siegler - Cooper University HospitalJoshua Willey - Columbia UniversityAdeel Zubair - Yale UniversityJoao Pedro Marto - Hospital de Egas MonizPiers Klein - Boston Medical CenterThanh Nguyen - Boston Medical CenterFarid Khasiyev - Saint Leo UniversityAlexis Simpkins - Cedars-Sinai Medical CenterMarwa Elnazeir - University of LouisvilleCheran Elangovan - University of Tennessee Health Science CenterBalaji Krishnaiah - University of Tennessee at Knoxville
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.57(Suppl_1)
- DOI
- 10.1161/str.57.suppl_1.WP127
- 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
- 9985132203302771
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