Evidence map›Paper›PMID 42132166›Full record

ArticleJournal of the American Heart Association2026

Possible Diagnostic Error in Cervical Artery Dissection: Analysis of STOP-CAD Study.

Ekaterina Bakradze, Liqi Shu, Shadi Yaghi, Thanh Lam Ngoc Tran, Ross Curtiss Crandal, Evan Lester, Daniel M Mandel, James Ernest Siegler, Mary Penckofer, Ava Leigh Liberman and 33 more

Abstract readMulticenter Study
In one paragraph

Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

43 authors.

Ekaterina BakradzeDepartment of Neurology University of Alabama at Birmingham Birmingham AL USA.ORCID 0000-0001-7534-7218
Liqi ShuDepartment of Neurology Brown University Providence RI USA.ORCID 0000-0002-9784-8475
Shadi YaghiDepartment of Neurology Brown University Providence RI USA.ORCID 0000-0003-0031-1004
Thanh Lam Ngoc TranHackensack University Medical Center Paramus NJ USA.
Ross Curtiss CrandalDepartment of Neurology Hennepin Healthcare Minneapolis MN USA.ORCID 0009-0003-7911-9724
Evan LesterDepartment of Medicine Weill Cornell Medicine New York NY USA.ORCID 0000-0002-8412-4152
Daniel M MandelDepartment of Neurology West Virginia University School of Medicine Bridgeport WV USA.ORCID 0000-0002-9484-4698
James Ernest SieglerDepartment of Neurology The University of Chicago Biological Sciences Chicago IL USA.ORCID 0000-0003-0287-3967
Mary PenckoferCooper Medical School of Rowan University Camden NJ USA.ORCID 0000-0002-7192-8557
Ava Leigh LibermanClinical and Translational Neuroscience Unit (CTNU) at the Feil Family Brain and Mind Research Institute, Weill Cornell Medicine New York NY USA.ORCID 0000-0003-0184-6035
Thalia S FieldVancouver Stroke Program, Division of Neurology University of British Columbia Vancouver British Columbia Canada.ORCID 0000-0002-1176-0633
Farhan KhanDepartment of Neurology Brown University Providence RI USA.ORCID 0000-0002-5958-6881
Wayneho KamDepartment of Neurology University of North Carolina Health Rex Raleigh NC USA.ORCID 0000-0002-6639-364X
Brian Mac GroryDepartment of Neurology Duke University Durham NC USA.ORCID 0000-0003-3914-8419
Faddi G Saleh VelezDepartment of Neurology University of Oklahoma OK USA.ORCID 0000-0002-2626-6259
Nils HenningerDepartment of Neurology University of Massachusetts Chan Medical School Worcester MA USA.ORCID 0000-0002-3883-5623
Cheran ElangovanDepartment of Neurology University of Tennessee at Memphis Memphis TN USA.ORCID 0000-0002-9473-8051
Balaji KrishnaiahDepartment of Neurology University of Tennessee at Memphis Memphis TN USA.ORCID 0000-0002-5825-1799
Preet GandhiVancouver Stroke Program, Division of Neurology University of British Columbia Vancouver British Columbia Canada.ORCID 0000-0001-5764-9781
Reza Bavarsad ShahripourDepartment of Neurology University of California at San Diego San Diego CA USA.ORCID 0000-0003-4805-529X
Malik GhannamDepartment of Neurology University of Iowa Iowa City IA USA.ORCID 0000-0003-2350-284X
Mirjam Rachel HeldnerDepartment of Neurology Inselspital, University hospital and University of Bern Switzerland.ORCID 0000-0002-3594-2159
Kateryna AntonenkoDepartment of Neurology Inselspital, University hospital and University of Bern Switzerland.ORCID 0000-0002-1936-5451
Aaron RothsteinDepartment of Neurology University of Pennsylvania Philadelphia PA USA.ORCID 0000-0002-8480-8220
Ronen R LekerDepartment of Neurology Hadassah-Hebrew University Medical Center Jerusalem Israel.ORCID 0000-0003-4794-0334
Issa MetanisDepartment of Neurology Hadassah-Hebrew University Medical Center Jerusalem Israel.ORCID 0009-0003-9902-7528
Edgar SamaniegoDepartment of Neurology University of Iowa Iowa City IA USA.ORCID 0000-0003-2764-2268
Michele RomoliNeurology and Stroke Unit, Department of Neuroscience Bufalini Hospital Cesena Italy.ORCID 0000-0001-8009-8543
Marialuisa ZeddeNeurology Unit, Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia Reggio Emilia Italy.ORCID 0000-0001-7530-818X
Rosario PascarellaNeurology Unit, Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia Reggio Emilia Italy.ORCID 0000-0002-0512-9298
Thanh N NguyenDepartment of Neurology Boston Medical Center Boston MA USA.ORCID 0000-0002-2810-1685
Piers KleinDepartment of Neurology Boston Medical Center Boston MA USA.ORCID 0000-0001-7468-137X
Farid KhasiyevDepartment of Neurology Saint Louis University Saint Louis MO USA.ORCID 0000-0002-3127-0973
Ossama KhazaalDepartment of Neurology Mohawk Valley Health System Utica NY USA.ORCID 0000-0002-8308-6596
Mohammad AlmajaliDepartment of Neurology University of Iowa Iowa City IA USA.ORCID 0000-0001-5051-6687
Adeel S ZubairDepartment of Neurology Yale New Haven Hospital New Haven CT USA.ORCID 0000-0002-9809-7888
Marwa ElnazeirDepartment of Neurology University of Louisville KY USA.ORCID 0000-0003-2697-0980
João Pedro MartoDepartment of Neurology Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental Lisbon Portugal.ORCID 0000-0003-2277-5950
Ahmad NehmeService de Neurologie, Université Caen Normandie, CHU Caen Normandie Caen France.ORCID 0000-0002-7700-6799
James Anthony GilesDepartment of Neurology Yale New Haven Hospital New Haven CT USA.ORCID 0000-0002-3197-3062
Stefan T EngelterDepartment Rehabilitation and Neurology, University Department of Geriatric Medicine, Department of Neurology and Department of Clinical Research University of Basel Switzerland.ORCID 0000-0003-3855-6234
Christoph StretzDepartment of Neurology Brown University Providence RI USA.ORCID 0000-0003-4125-4077
Setareh Salehi OmranDepartment of Neurology University of Colorado Anschutz Medical Campus Aurora CO USA.ORCID 0000-0002-3184-5327

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCervical artery dissection (CeAD) is a common cause of stroke in young adults but is frequently misdiagnosed due to its nonspecific symptoms. This study examines factors associated with possible diagnostic error in CeAD and evaluates its impact on patient outcomes.

methodsWe conducted a secondary analysis of the STOP-CAD (Antithrombotic Therapy for Stroke Prevention in Cervical Artery Dissection) study, which is a multicenter international study of adult patients admitted with CeAD. Possible diagnostic error was defined as the presence of CeAD symptoms within 30 days before the index CeAD diagnosis. The comparison group included patients diagnosed on their first medical encounter. Multivariable regression was used to identify factors associated with possible diagnostic error. Primary and secondary outcomes included ischemic stroke, death, and modified Rankin Scale score <2.

resultsOf 4012 patients (mean age 47.5 years, 44.6% female), 663 (16.5%) experienced possible diagnostic error. Among these, 224 (33.8%) reported to have ischemic stroke before CeAD diagnosis. Patients with possible diagnostic error were younger (odds ratio [OR], 0.89,

conclusionsOne in 6 patients with CeAD experienced a possible diagnostic error, particularly those who were younger, had migraines, or presented with headaches and nonfocal symptoms.

Indexed as

Carotid Artery, Internal, DissectionDiagnostic ErrorsIschemic StrokeVertebral Artery DissectionAdultAge FactorsFemaleHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPredictive Value of TestsRisk FactorsStrokedissectionmisdiagnosisstroke

Identifiers

PMID42132166
PMCPMC13279552

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