Typical case: A 13-year-old female child was admitted to the hospital with the chief complaint of “intermittent headache with blurred vision in both eyes for 1 week”. History: The patient had headache with no obvious cause 1 week ago, with intermittent attacks lasting about 1 minute, which could be relieved by itself, accompanied by nausea, blurred vision and distension in both eyes, no lacrimation, no diplopia, no rotation of vision, no vertigo, no hearing abnormality, no limb movement disorder, no twitching of limbs, etc. The cranial MRI at the First Affiliated Hospital of Qiqihar Medical College suggested that pineal cell tumor and obstructive hydrocephalus. He was physically fit in the past. On admission, the pupils were equally large and round, with a diameter of 2,5 mm. Preoperatively (2015-07-21) cranial MRI at the Affiliated Hospital of Qiqihar Medical College: a mass-like slightly long T1 and slightly long T2 signal shadow was seen in the pineal region on plain scan, with uneven signal within it and still clear margins, the lesion compressed the midbrain aqueduct, the supratentorial ventricles were dilated, and striated high signal was seen around the bilateral ventricles on pressurized water image. The lesion in the pineal region showed moderate heterogeneous enhancement, with a size of 21mm*12mm*23mm, and was closely related to the midbrain and intracerebral veins. As shown in the figure below: Preoperative cranial CT of Beijing Armed Police General Hospital suggested that the pineal region was occupied and obstructive hydrocephalus was present. After completing the relevant tests, a Poppen approach was performed on July 21, 2015 under general anesthesia to remove the occupancy in the pineal region, and the operation went smoothly, and the organ was removed and returned to the ward after the operation. A cranial CT examination on the first postoperative day showed no significant bleeding in the operative area. The patient was treated with symptomatic drugs such as dehydration and cranial pressure reduction, hemostasis and seizure prevention after surgery. The results of both the Armed Police General Hospital and Beijing Tiantan Neuropathological Institute suggested: germ cell tumor in the pineal region. The patient requested to be discharged on July 31, 2015. At the time of discharge, the patient’s blurred vision and diplopia symptoms did not improve significantly, and her vital signs were stable with no other uncomfortable symptoms.