Motiei-Langroudi et al evaluated patients with aneurysmal subarachnoid hemorrhage who required permanent diversion of CSF to prevent hydrocephalus. One key finding is the inability to wean the patient from an external ventricular drain inserted to relieve acute hydrocephalus. The authors are from Beth Israel Deaconess Medical Center, University of Alabama, INOVA Health Systems, Seattle Science Foundation and Tabriz University in Iran.