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Istanbul University, Istanbul Faculty of Medicine, Department of Neurosurgery, Istanbul, Turkey DOI : 10.5137/1019-5149.JTN.5822-12.0 Tension pneumocephalus is a rare and life threatening complication of intracranial surgical procedures, and requires immediate recognition and surgical intervention. Tension pneumocephalus following ventriculoperitoneal shunt surgery is extremely rare and commonly seen as a delayed complication. To our knowledge, early postoperative tension pneumocephalus after shunt surgery was reported only in one other publication. We present a case of acute tension pneumocephalus following ventriculoperitoneal shunt surgery for normal pressure hydrocephalus, which was managed well with close neurological follow-up and rapid surgical intervention. The use of the portable CT scanner in this case saved significant time, without the transport of the patient to the radiology unit, made early surgical intervention possible, and prevented morbidity and mortality. Keywords : Tension pneumocephalus, Ventriculoperitoneal shunt surgery, Portable CT scanner, Emergency surgery