Recurrent Cervical Artery Dissection Prevalence and Predictors: A Secondary Analysis of the STOP-CAD Study
João Pedro Marto1,2, Liqi Shu3, Eileen Wu4
1Department of Neurology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal (J.P.M.).
Stroke
|January 12, 2026
Summary
Recurrent cervical artery dissection (CeAD) is uncommon, with a 2-year risk of 3.22%. Factors like younger age, migraine, and fibromuscular dysplasia increase risk, while stroke may decrease it.
Area of Science:
- Neurology
- Vascular Medicine
- Epidemiology
Background:
- Cervical artery dissection (CeAD) can recur, but its frequency and risk factors are not well-defined.
- Understanding recurrence is crucial for patient management and risk stratification.
Purpose of the Study:
- To determine the frequency, associated factors, and clinical impact of recurrent CeAD.
- To identify predictors of CeAD recurrence.
Main Methods:
- Retrospective observational study (STOP-CAD) of patients with CeAD.
- Kaplan-Meier estimates for absolute risk; multivariable logistic and Cox regression for predictors.
- Follow-up from day 7 to 2 years post-index event.
Main Results:
- Recurrent CeAD occurred in 2.29% of patients over a median follow-up of 295 days.
- Estimated 2-year risk of recurrence was 3.22%.
- Younger age, migraine, and fibromuscular dysplasia were associated with increased recurrence risk; ischemic stroke at presentation was associated with decreased risk.
Conclusions:
- Recurrent CeAD is uncommon and rarely leads to new ischemic events.
- Younger age, migraine, fibromuscular dysplasia, and absence of stroke at presentation can identify high-risk individuals.
- These findings aid in risk stratification and management of CeAD patients.
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