Absolutely! Tricky, right? Cryptococcal meningitis is unique in that you do actually need to remove CSF, even by performing serial LPs! This runs counter to conventional teaching to avoid LPs in intracranial hypertension due to the concern for causing cerebral herniation. Lowering her ICP in this fashion will actually reduce her mortality. Crypto is unique like that, and knowing and recognizing this will help you save a life. Depending on the circumstances, you might be consulted to consider placing a lumbar drain (to save them from numerous taps) or even an EVD to help manage this patient's intracranial hypertension. This is worth consideration if you find it to be technically feasible. Plateau waves are not always known by neurologists and neurosurgeons alike, so understanding the phenomenon and being able to explain it can help ensure the appropriate treatment is pursued.
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