In this report, we present a case of peripheral facial nerve palsy (FNP) due to injury of the facial nerve trunk that occurred during tunneling of a VP shunt catheter. We aimed to present the preventive measures by taking the anatomical causes of this complication. A 75-year old was stated a VP shunt surgery for treatment of Normal Pressure Hydrocephalus (NPH). His physical examination of skull was revealed ecchymosis behind the right ear. The neurological examination revealed a peripheral FNP (Grade IV, House? Brackmann Facial Nerve Grading System) with no alteration in lacrimation and taste sensation. A computed tomography (CT) detected edema of the extratemporal segment of right facial nerve. Surgeons performing ventriculoperitoneal shunt surgery should have comprehensive knowledge of the anatomical course of facial nerve. In this way, they can beware to proper placement of the shunt catheter during the tunnelling procedure to prevent complications.
