Symptomatic tension pneumocephalus following Palacos® cranioplasty in a shunted patient.

Tension pneumocephalus is an exceedingly rare complication of cerebrospinal fluid diversion occurring after surgery, trauma or spontaneous fistula formation. We report a case in a patient with a ventriculoperitoneal shunt who developed symptomatic tension pneumocephalus via a skin defect within 24 hours of undergoing bone cement cranioplasty.