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Wakayama Rosai Hospital, Department of Neurosurgery, Wakayama, Japan DOI : 10.5137/1019-5149.JTN.7928-13.0 A patient received a ventriculoperitoneal shunt operation for hydrocephalus after subarachnoid hemorrhage. Postoperative computed tomography incidentally revealed asymptomatic pneumothorax caused by a shunt tube passing through the thoracic space. The patient was observed without removal of the tube or chest drainage, with the expectation of spontaneous recovery. However, the pneumothorax was not cured, and chest drainage was performed and eventually resolved the pneumothorax. The ventriculoperitoneal shunt worked well, and the patient recovered from consciousness disturbance. We discuss treatment strategies for this rare complication and how to avoid it. A review of the literature suggests that female or obese patients may be associated with this complication. Keywords : Chest drainage, Complication, Pneumothorax, Ventriculoperitoneal shunt