Postpartum dissecting aneurysm of the basilar artery.

Abstract

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