The patient gets an EVD placed. It's left open to drain at 15cmH2O at the tragus. About 10mL of CSF is drained initially. This results in significant improvement in his ICPs. He still requires some occasional boluses of sedation, analgesia, and hyperosmolar therapy over the next week. Due to prolonged intubation with inability to extubate due to his poor mentation, he requires a bedside percutaneous tracheostomy. Things eventually settle down, and his EVD and ICP monitor are able to be removed as his ICPs consistently remain normal and his clinical status improves.
He's transferred to the floor after spending three weeks in the NCCU. He's eventually discharged to LTAC. There, he gradually recovers consciousness within the next month. He's able to be transferred to IPR, where he undergoes extensive rehabilitation. He's able to be discharged home with assistance, about five months from his initial ED presentation.
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