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The last line of my previous post should actually read 
 python.exe setup.py bdist_wininst
Anyway, here are three files (also attached) that can reproduce the problem:
1) setup.py
from distutils.core import setup, Extension
setup(name='testpyd', scripts = ["testpyd_postinstall.py"],
 ext_modules=[Extension('testpyd', ['testpyd.c'],)],
 options = {"bdist_wininst": {"install_script": 
 "testpyd_postinstall.py", "user_access_control": "auto"},})
2) testpyd.c
#include "Python.h"
PyMethodDef methods[] = {{NULL, NULL},};
void inittestpyd() {(void)Py_InitModule("testpyd", methods);}
3) testpyd_postinstall.py
#!python
import testpyd
Build the installer with python 2.6 and Issue4120 patch applied:
 python setup.py bdist_wininst
Run the installer:
 dist\testpyd-0.0.0.win32-py2.6.exe
The postinstall script fails with:
Traceback (most recent call last):
 File "<string>", line 1, in <module>
ImportError: DLL load failed: The specified module could not be found.
According to Sysinternals process monitor python26.dll is loaded from the system32 directory, the testpyd.pyd extension is found at the right place, and then the Windows path is searched in vain for MSVCR90.DLL.
Tested on Windows 7 Pro 64 bit.