Patients with advanced melanoma brain metastases resulting in lethargy are somewhat conscious, but will be unconscious when the disease worsens to deep coma and beyond. Melanoma can metastasize to the patient’s brain system through the bloodstream, and brain metastases may cause psychiatric symptoms such as hemiparesis, aphasia, and seizures. Advanced melanoma brain metastases can also cause symptoms of elevated intracranial pressure, which can manifest as progressive worsening of headaches, accompanied by nausea and vomiting. When the tumor has metastasized to the base of the skull, it can invade and damage multiple groups of cranial nerves, and tumor metabolites may also produce arachnoiditis. The damage caused by melanoma brain metastasis is huge, if not treated in time, it will seriously jeopardize the patient’s life and health. If brain metastasis has occurred, it is necessary to seek medical treatment in time, and patients and their families should keep optimistic mentality and actively cooperate with doctors for treatment.