AIM: To show the abnormal cerebral hemodynamics, in high-pressure hydrocephalic patients, could be restored by shunt surgery, and the tympanic membrane temperature (TMT) could be used to non-invasively monitor this recovery process. MATERIAL and METHODS: One-hundred-and-four patients, with high-pressure hydrocephalus (spinal tap opening pressure >180 mmH(2)O), were prospectively enrolled in our study. The computed tomography perfusion (CTP) was scheduled for 7-10 days pre-and post-shunt surgery. The TMT and Glasgow Coma Scale (GCS) scores were collected during the same session. RESULTS: The CTP after the shunt surgery revealed a significant increase in cerebral blood volume (CBV) in both hemispheres (p<0.05). More specifically, this CBV increase was observed in the midbrain, cerebellum, basal ganglion, temporal lobe, and frontal lobe regions (all p<0.05). Simultaneously, patients' post-surgical TMT and GCS scores also increased compared to their pre-surgical scores since the first post-shunt follow-up (p<0.01). Notably, while the GCS scores continued to increase during the post-shunt follow-up, the TMT exhibited a fluctuation period after the shunt and required seven days to reach a steady state. CONCLUSION: Our study revealed that a shunt could significantly increase cerebral perfusion in high-pressure hydrocephalic patients in a region-specific manner. During the perioperative period of hydrocephalus, TMT can be used to monitor cerebral hemodynamic changes.