Post-meningitic subdural effusion does not extend extracranially. To our knowledge, the association of hydrocephalus and extracranial extension of a subdural effusion has not been previously reported. We present a case of an 8-year-old boy who presented with progressive head enlargement and worsening pulsatile peri-orbital swelling of 1 year duration. Cranial computerized tomographic scan confirmed communicating hydrocephalus and bilateral subdural effusion worse on the right side. The patient had a ventriculo-peritoneal shunt, with resolution of the subdural effusion and his hydrocephalus.