Intraventricular Pneumocephalus Complicating Pneumothorax in a Case of Ventriculopleural Shunt: A Rare Complication and Its Management

The peritoneal cavity is widely used as the destination of choice for cerebrospinal fl uid (CSF) shunts. Various alternative distal sites have been used, particularly in the presence of certain contraindications, which include the cardiac atria, for ventriculoatrial (VA) shunt, or the pleural cavity for ventriculopleural (VPL) shunt. 1 Each procedure is associatedwith its own set ofcomplications and the choice of selection of the distal site of CSF drainage is often based on surgeon ’ s preference along with patient ’ s factors. 2 While the historical literature describes pleural effusion and pneumothorax as complications of a VPL shunt, there is paucity of data justifying the application of one technique over the other. We report a rare case of postoperative pneumothorax in a case of VPL shunt being further complicated by pneumocephalus. A 41-year-oldgentleman, who is a known case ofoperated grade II tectal plate glioma with hydrocephalus for which resection of glioma and ventriculoperitoneal (VP) shunt