The true story of a young girl in her prime, through her painful experience and the consultation process, tells you the importance of early diagnosis of skull base deformity. When she first started junior high school, she noticed that her neck was shorter than other students. Little felt very aggrieved because she had difficulty controlling her own hand and foot movements. She was told that her spinal cord disease was the cause of the problem, and she ate a lot of drugs and supplements, but her symptoms did not improve. Finally, I heard that the spinal cord disease should be treated by a neurosurgeon, so I went to a neurosurgery clinic after a lot of trouble. In fact, this is a congenital malformation, commonly known as a cervical vertebrae into the cranial cavity due to the depression of the skull base, so it looks like the neck is short. The “head falling into the neck” can cause nerve compression, cerebrospinal fluid circulation obstruction, spinal cord cavity and medullary symptoms. The disease is usually not obvious in early childhood, but as the child gets older, the nerve compression becomes more severe, leading to paraplegia and life-threatening respiratory distress. The child was admitted to the hospital the same day and underwent surgery for repositioning, decompression and fixation immediately afterwards. After relaxing the muscles under general anesthesia, I carefully pulled Xiao’s skull out of the spinal canal slowly, then removed part of the sunken occipital bone to enlarge the cranial cavity to allow adequate decompression of the medulla oblongata, and finally implanted and fixed the artificial bone. After the operation, Xiao felt a lot more relaxed all of a sudden. During the next day’s checkup, with the encouragement of Director Zhong, Xiao slowly got out of bed and stood up, and although he still felt weak, he could walk normally. Skull base depression is caused by congenital bone dysplasia, most patients progress slowly, some may be asymptomatic and only found during X-ray examination. The clinical manifestations may vary depending on the degree of deformity and comorbidities, but generally the first symptoms are neck ankylosis and progressive lower limb weakness; in the process of progressive aggravation, minor head trauma (head tilt or excessive neck flexion) may cause tetraplegia and respiratory disturbances. In this case, the disease was not discovered too late (but the cavity in the spinal cord that has been caused will take three months to recover slowly after surgery), and in the future it will not be too different from a normal child except for the limited movement of the neck. Finally, we remind that the earlier the skull base depression is detected, the better the treatment effect will be. Parents should come to the neurosurgery department in time if they find that their children have short neck, low hairline, or cranial malformation.