• Qiaowei Wu, Tianxiao Li, Li Li, Kaitao Chang, and Qiuji Shao.
• Cerebrovascular Department of Interventional Center, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Zhengzhou, Henan, China.
• Medicine (Baltimore). 2022 Nov 25; 101 (47): e31444e31444.

RationaleIntracranial vertebrobasilar dissecting aneurysms (VBDAs) are associated with a greater tendency to rupture and a greater risk of worse outcomes than anterior circulation aneurysms. Spontaneous healing of a VBDA is very rare, and there have been very few case reports of spontaneous healing of an aneurysm. We describe a case of intracranial vertebral artery dissecting aneurysm that healed spontaneously and disappeared completely on follow-up images.Patient ConcernsA 40-years-old woman was referred to the neurology department because of a persistent headache, especially in the left occiput.DiagnosesMagnetic resonance angiography and computed tomography angiography showed a left vertebral artery dissection-like aneurysm (4.5 × 2.0 × 2.5 mm in size) with proximal parent artery mild stenosis (40%).InterventionsFlunarizine hydrochloride was administered for symptomatic treatment and follow-up angiography was performed.OutcomesDigital subtraction angiography and magnetic resonance angiography showed that the aneurysm had completely disappeared at 3 months follow-up. High-resolution magnetic resonance vessel wall imaging revealed intimal thickening and mild stenosis in the left intracranial vertebral artery without an aneurysm signal. In addition, enhancement scanning revealed that the aneurysm area was moderately enhanced. MR-vessel wall imaging at 7 months follow-up showed that the enhancement was slightly reduced compared with the previous time.LessonsThis case illustrates the relatively plastic nature of a vertebral dissecting aneurysm, indicating that spontaneous healing remains possible.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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