A 1-year-old girl presented with an overly enlarged head for 5 months. Ignorance of parents regarding treatment for this enlarged head is concerning. Early treatment can avoid a lot of complications. Hydrocephalus secondary to aqueductal stenosis was diagnosed after a thorough history, examination, and investigations. Endoscopic Third Ventriculostomy was performed.

Total intracranial shunt migration is an extremely rare complication following ventriculoperitoneal shunting and it occurs probably due to raised intra-peritoneal pressure, strong head movements, and inadequate shunt fixation. The best possible approach to prevent shunt migration would be better patient handling along with appropriate operative techniques.