Female child, 6 years old; complained of sudden onset of syncope for 9 days; previously healthy. Present history: 9 days ago, the patient fell while playing and did not land on her head. After picking her up, she had a sudden loss of consciousness, with involuntary opening and closing of both eyes, no tonicity or tremor of the limbs, and gradual recovery of consciousness after 10 seconds. After waking up, he did not complain of headache or dizziness, and did not experience nausea or vomiting. No similar seizures were seen afterwards. The patient’s parents therefore consulted the Affiliated Hospital of Taishan Medical College in Taian City, Shandong Province on the following day, and performed cranial CT and MRI successively to show: intracranial occupancy. For further consultation and treatment, the patient was referred to our hospital. Physical examination: The patient was clear and articulate, and walked into the ward. The visual field of both eyes was normal on gross measurement, the pupils were equal in size and round, the reflex to light was sensitive and symmetrical, the movement of both eyes was adequate in all directions, the facial lines were symmetrical, the uvula was in the center, the gag reflex existed, the shrugging was symmetrical and strong, the tongue extension was in the center; the sensory system did not show any obvious abnormality, the muscle strength of the limbs was grade V, the physiological reflex existed, the pathological reflex was not elicited. The meningeal stimulation sign was negative. The alternating test, finger-nose test, and closed-eye difficult-to-stand sign were negative. Preoperative imaging data: head CT showed an abnormal occupying image in the four ventricles with a slightly high density and calcification. MRI of the head showed that the lesion in the four ventricles showed slightly long T1 and long T2 signals, and enhancement showed heterogeneous enhancement of the lesion. Surgery: suboccipital posterior median approach tumor resection. Postoperative pathology showed: ventricular meningioma. Postoperative review MRI showed that the tumor was completely resected. Discussion 1. Ventricular meningioma: originated from ventricular meningeal cells, mostly seen in children and adolescents, with low signal on T1WI and high signal on T2WI; cystic changes may occur, peritumoral edema is rare, and strengthening is not as obvious as medulloblastoma; tumor margins are mostly lobulated but irregular, and may grow toward the lateral and/or median foramen. Ventricular meningioma occurs in the lower and middle parts of the fourth ventricle. The cerebrospinal fluid signal around the tumor is mainly located in the posterior part of the tumor. There is mostly calcification. Medulloblastoma is the most common malignant tumor of the central nervous system in children, originating from the neuroepithelial tissue of the cerebellum, accounting for about 20% of intracranial tumors in children and 40% of posterior cranial fossa tumors in children, with peak incidence around the age of 8. The tissue origin of the tumor has been under debate for many years. There are two possible sources of tissue: one originates from subventricular stromal cells, which can develop into deep nuclei of neurons, The other origin is neuroblastoma cells in the outer cerebellar granular layer, which gradually migrate to the inner cerebellar granular layer after development. Glioma: Most of the lesions are located in the cerebellar hemispheres, with irregular mass margins and less frequent supratentorial ventricular enlargement, low signal in T1WI and high signal in T2WI. The mean contrast passage time and time-signal curve of contrast outflow segment were not as obvious as those of medulloblastoma.