Postpartum dissecting aneurysm of the basilar artery.

BACKGROUND AND PURPOSE: Dissecting aneurysms arising from the vertebrobasilar complex are rare and difficult to manage. More of their natural history needs to be known before treatment can be optimized.

CASE DESCRIPTION: We report a postpartum dissecting aneurysm of the right vertebrobasilar artery in a 31-year-old woman that was confirmed by angiographic identification of a double lumen. The intracranial segment of the right vertebral artery was thrombosed proximal to the aneurysm. The patient, managed conservatively, recovered well and, when reexamined 2 months later, was found to be neurologically intact. A repeat angiographic study at that time demonstrated that the aneurysm had resolved.

CONCLUSIONS

Proximal occlusion may have protected the aneurysm from rupture and further dissection, thereby making surgery unnecessary.