Ventriculoperitoneal Shunt surgery is a common neurosurgical procedure comprises a long list of postoperative complications. Among them, common complications like shunt infection, obstruction, overdrainage or underdrainge, subdural hematoma or hygromas are reviewed extensively in the previous literature.1 With the course of time, improved surgical and technical skill, use of programmable valves, antibiotic impregnated catheters, attempt to improve nutritional status of the child before placement of shunt reduces significant shunt related morbidities. Despite all these precautions and techniques there are some rare complications of this surgery which can leads to catastrophic outcome. In this case series we reported four rare complications of VP shunt surgery and reviewed the previously reported literature. We also focused on the possible risk factors, pathophysiology of each complications so that meticulous attention can be given to prevent these complications to improve surgical outcome.

Keywords: VP shunt; Calcified extradural hematoma; Intracerebral hemorrhage; Ascities, Pseudocyst, SEGA