Typical case: A 13-year-old female was admitted to the hospital with the chief complaint of “intermittent headache with blurred vision in both eyes for 1 week”. History: One week ago, the patient had a headache with no obvious triggers, intermittent episodes, lasting about 1 minute, which could be relieved on its own, accompanied by nausea, blurred vision and distension in both eyes, no tears, no diplopia, no vision rotation, no vertigo, no hearing abnormality, no impaired limb movement, no limb convulsions, etc. In the First Affiliated Hospital of the Medical College of Qiqihar, a cranial MRI showed that pinealocytoma was considered and obstructive hydrocephalus was found in the patient. Obstructive hydrocephalus. She came to our hospital for further surgical treatment, and was admitted to our department as an outpatient with the diagnosis of “pineal body space”. She had a healthy body. Admission examination: bilateral pupils were equal in size and round, 2.5mm in diameter, sensitive to light reflex, bilateral visual acuity, no obvious change in the visual field, and no obvious abnormality in the rest of the examination. Preoperative (2015-07-21) Qiqihar Medical College Affiliated First Hospital cranial MRI: plain scanning pineal region see lumpy slightly long T1 slightly long T2 signal shadow, the signal within it is uneven, the edge is still clear, the lesion compression of the midbrain conduit, the curtain ventricle dilatation, the pressurized water image of bilateral ventricles around the cerebral cords see a high signal. Enhanced scan showed moderate uneven enhancement in the pineal region, the size of the lesion was 21mm*12mm*23mm, and the lesion was closely related to the midbrain and intracerebral veins. The preoperative cranial CT of Beijing Armed Police General Hospital suggested that the pineal region was occupied and obstructive hydrocephalus. After completing the relevant examinations, the operation was performed under general anesthesia on July 21, 2015 with Poppen approach pineal region occupancy resection, the operation went smoothly, and the organ intubation was removed after the operation and returned to the ward. Cranial CT examination was performed on the first postoperative day, suggesting that there was no obvious hemorrhage in the operated area. The patient was given postoperative medication to reduce cranial pressure with dehydration, stop bleeding and prevent epilepsy. The patient’s postoperative blurred vision and diplopia did not improve significantly, and she did not complain of any other discomforts. The results of Beijing Tiantan Institute of Neuropathology all suggested: pineal region germ cell tumor. The patient requested to be discharged from the hospital on July 31, 2015, and at the time of discharge, the patient’s blurred vision and diplopia symptoms had not improved significantly, and her vital signs were stable, with no other discomforts.