We describe two cases of tension pneumocephalus, one caused by ventriculoperitoneal shunt for communicating hydrocephalus, and the other caused by craniocerebral trauma. In the first case report, we examined the relationship between cerebrospinal fluid leakage and delayed onset tension pneumocephalus. The second case report, we addressed issues such as the diagnosis, management, and pathogenesis, as well as computerized tomography(CT) findings.