A 33-year-old woman admitted to the ICU due to intraventricular hemorrhage. An arteriography is performed where an abnormal venous drainage is appreciated and an MRI is performed where signs of venous thrombosis are ruled out. The patient was going to be discharged to the Neurosurgery ward with GCS 15 points, without focality. Headache poorly controlled with conventional analgesia. He did have significant stiffness in the neck. Nausea with improvement after administration of granisetron. Throughout the afternoon, neurological deterioration began until a GCS of 10 points (O2V3M5), we performed a brain CT in which a significant increase in the hydrocephalus component was observed compared to previous neuroimaging. Neurosurgery is contacted, deciding to implant EVD

She woke up without focality and was extubated without incident.

She remains conscious and oriented, with better pain control, without apparent focality. GCS: 15 points (M: 6, O: 3, V: 5). It maintains hemodynamic stability, diuresis and renal function. EVD at 18 cm H2O with output of 140 cc of CSF with a stained serous appearance. PiC and PPC in range. Control CT slope.

Restarted oral diet with excellent tolerance. I request a control test with an increase in CRP to 5 mg/dL. Normal rest. Good gas exchange. CSF culture taken today. Strictly normal arterial blood gases. Eupneic to room air.