A patient with headache and blurred vision was found to have craniopharyngiopharyngeal tumor, whose occupying effect and obstruction of the interventricular foramen caused high cranial pressure; the tumor compressed the optic chiasm and optic nerve and caused visual impairment; the tumor compressed the hypothalamus and pituitary and caused hypothalamic-pituitary dysfunction; and part of the tumor encroached on other brain tissues and caused neurological and psychiatric symptoms. After microsurgery, the patient recovered successfully. Reviewing the patient’s symptoms, there are three points. 1. Increased intracranial pressure Mostly due to obstructive hydrocephalus caused by the tumor blocking the interventricular foramen, and the occupying effect of the huge tumor itself is also one of the causes of increased intracranial pressure. The symptoms include headache, vomiting, optic disk edema or secondary optic atrophy. Visual field obstruction: The tumor compresses the optic cross, which may cause primary atrophy of optic nerve and bi-temporal hemianopsia; increased intracranial pressure may cause optic disk edema, and secondary atrophy of optic nerve and centripetal narrowing of visual field may be seen in the late stage. Foster-Kennedy syndrome can be seen when a few tumors develop into the anterior cranial fossa. Endocrine function disorders Because of the compression of pituitary gland, its secretion of growth hormone, thyroid stimulating hormone, adrenocorticotropic hormone and gonadotropin will be reduced, which will be manifested as growth retardation, dry skin and non-development of secondary sexual characteristics. Due to the compression of the inferior colliculus, there may be lethargy, uremia, fat metabolism disorders (mostly centripetal obesity, a few can be highly malnourished and malignant), thermoregulation disorders (body temperature is lower than normal), and so on. The microscopic neurosurgical operation process is shown in the figure: Craniopharyngioma has a clear boundary with the surrounding tissues, but its size, shape, and growth range vary greatly. The largest is like a goose egg, and the smallest is as big as a peanut meter. They are spherical, irregular and nodular in shape. Most of them are cystic in nature, and the substantial ones are not seen. The thickness of the wall of the capsule is very different, some are as thin as windowpaper, through the thin wall of the capsule that can be seen the color of the liquid, mostly yellow-brown. Some cyst wall is thicker and grayish-white with most calcified spots, which is the characteristic performance of craniopharyngioma. The wall of the capsule is usually free and does not adhere to the surrounding tissues. If the tumor is substantial or partially substantial, sometimes it often adheres to the important structures of the skull base, resulting in compression and corresponding clinical symptoms, such as compression of the pituitary stalk, subthalamus, cavernous sinus, optic cross and internal carotid artery. There are two reasons for the development of craniopharyngioma: 1, congenital residual theory, the embryo 7-8 weeks craniopharyngiopharyngeal tube that is gradually disappeared, in the process of development, there are often epithelial cells nests left, that is to say, it has become a craniopharyngioma of the source of the organization. Therefore, craniopharyngioma can occur in the pharynx, pterygoid sinus, saddle, saddle and the third ventricle, and some can invade the posterior cranial fossa.2. Squamous epithelial chemotaxis theory, which is considered to be a mixture of pituitary gland cells and squamous epithelial cells, and there is an excess of the two seen, which is a discovery that supports the chemotaxis theory as well.