Would you recommend temporary EVD or more permanently VPS to lower ICP?  

We only place EVDs in patients who meet criteria with a GCS of 8 or less. If they are a GCS 9 or greater, we empirically manage cerebral edema if we think it is present, but do not monitor ICP with invasive devices.  With regards to VPS, we never use them acutely to lower ICP. Shunts are only ...