Case-Based Modules > Case 10 > Stage 3

Sorry! It's true that the evolving cytotoxic edema is causing ventricular entrapment. However, putting an EVD in (for this patient, it'd be right-sided) would end up increasing a pressure gradient by lowering the pressure in the right hemisphere. This would exacerbate the patient's cerebral herniation, which is caused by the pressure vector moreso than actual raw increased value of ICP. An EVD could be considered as an adjunct to the best next treatment step, but should not be performed alone. What else could you do to address this burgeoning herniation?

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