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Rationale:A 45-year-old right-handed female patient suffered head trauma after being hit by a truck that ran into a house.Patient concerns:The patient lost consciousness for 1 hour and experienced posttraumatic amnesia for 1 month after the accident.Diagnoses:She underwent conservative management for a subdural hematoma in the left frontotemporal lobes and intracerebral hematoma in the left frontal lobe.Interventions:The patient's Glasgow Coma Scale score was 11. She underwent a VP shunt operation, approached through the right posterior parietal area of the brain, at 4 months after onset. Approximately, 6 months after onset, she was admitted to the rehabilitation department of a university hospital. She presented with moderate weakness of the left leg: Medical Research Council scores: hip flexor; 3, knee extensor; 3+, ankle dorsiflexor; 3–. Brain magnetic resonance imaging revealed a leukomalactic lesion in the right posterior corona radiata along the shunt.Outcomes:On 6-month (2 months after the shunt operation) diffusion tensor tractography, the left CST showed partial injury in the posterior portion compared with the right CST. On 6-month transcranial magnetic stimulation study, the motor-evoked potential obtained at the left tibialis anterior muscle revealed lower amplitude than that on the right side.Lessons:Injury of leg somatotopy of a CST was demonstrated in a patient with leg weakness following a VP shunt operation.