en Gamma Knife Radiosurgery Case report <p style="text-align: justify;"><strong>Background & Importance:</strong> Acute epidural hematoma is a very rare complication of ventriculoperitoneal shunt&nbsp;insertion. The insertion of a ventriculoperitoneal shunt can cause sudden decompression of the brain, subsequent to&nbsp;which epidural hematoma occurs due to CSF drainage. To our knowledge, there are only a few cases of acute epidural hematoma in the literature which required acute evacuation.</p> <p style="text-align: justify;"><strong>Case Presentation:</strong> In this report, we present a case of epidural hematoma close to ventriculoperitoneral shunt insertion&nbsp;site in a 30-year-old man after failure of endoscopic surgery for opening of the wall of a suprasellar arachnoid cyst.&nbsp;Secondary to communication between cyst and ventricles and clinical symptoms and sings, the patient underwent the&nbsp;shunt insertion. The patient became comatose two hours following the insertion of the shunt, developing a voluminous&nbsp;right temporo-parietal epidural hematoma that had to be evacuated immediately. Here, we intend to discuss both the pathophysiology and treatment.</p> <p style="text-align: justify;"><strong>Conclusion: </strong>Development of epidural hematoma after ventriculoperitoneal shunt surgery is a devastating complication.&nbsp;Dehisensce formation between the skull and dura matter, which may be facilitated by lax adhesion between the two,&nbsp;is a common underlying pathology. We recommend a close post-surgical observation for immediate diagnosis and reoperation&nbsp;of this event.</p> Acute, Epidural, Hematoma, Ventriculoperitoneal shunt 30 32 http://irjns.org/browse.php?a_code=A-10-100-32&slc_lang=en&sid=1 Hamid Etemadrezaie حمید اعتمادرضایی 10031947532846003044 10031947532846003044 No MD, Assistant Professor of Neurosurgery, Department of Neurosurgery, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran Samira Zabihian سمیرا زبیحیان 10031947532846003045 10031947532846003045 No MD, Assistant Professor of Neurosurgery, Department of Neurosurgery, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran Humain Baharvahdat هومن بهاروحدت 10031947532846003046 10031947532846003046 No MD, Assistant Professor of Neurosurgery, Department of Neurosurgery, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran Babak Ganjeifar بابک گنجه ای فر 10031947532846003047 10031947532846003047 Yes MD, Assistant Professor of Neurosurgery, Department of Neurosurgery, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran