This episode critically examines the comparative safety and effectiveness of bolt-mounted versus tunnelled external ventricular drains (EVDs) in neurocritical care. Drawing from a systematic review, meta-analysis, and trial-sequential analysis published in the Journal of Clinical Neuroscience in 2026, this abstract-based discussion addresses the persistent heterogeneity in EVD procedural techniques. The analysis synthesizes existing data to clarify the relative risks and benefits of each fixation method, offering valuable insights for optimizing patient care and guiding future research. This information is intended for educational purposes and is not a substitute for professional medical advice. AI-generated content may contain errors or omissions.