Brainstem tumors are risky and difficult to operate because of the special tumor site. Recently, Xiangya Hospital neurosurgery team comprehensively used a variety of modern neurosurgical techniques to successfully implement the surgery for a patient with postoperative tumor recurrence of huge occupying lesion in the right side of brain bridge and midbrain. According to the introduction, this year’s 17-year-old patient Xiong Mou, from Jiangxi Province, was diagnosed in 2013 with a huge space-occupying lesion in the right side of the brain bridge, midbrain, and that year to a large hospital in Beijing for surgery and radiation therapy, but unfortunately, the tumor recurred after surgery. At a loss, Xiong was introduced to Xiangya Hospital’s Department of Neurosurgery in October 2014 by a patient friend. “The location of this patient’s brainstem tumor is very special, and the literature reports high surgical mortality and disability rate in this region, as well as poor prognosis, which affects the quality of life of patients after surgery.” Li Xuejun, deputy director of the case, said that the patient was a postoperative recurrence and radiotherapy patients, relatively speaking, the operation is more difficult, “we decided to change the idea of surgery”. Li Xuejun of the Department of Neurosurgery, Xiangya Hospital, Central South University, after meticulous preoperative consultation and discussion among all the experts in Ward 35, Associate Professor Li Xuejun formulated a detailed diagnosis and treatment plan for the patient. on October 15, Associate Professor Li Xuejun of the Department of Neurosurgery, and Wang Goushi Yi, Attending Physician of the Department of Neurosurgery, comprehensively utilized the combination of MRI (magnetic resonance imaging) with Diffusion Tensor Imaging (DTI), and other functional magnetic resonance imaging (fMRI) special examination sequences, intraoperative neuronavigation, and intraoperative neuronavigation. examination sequences combined with MRI (DTI), intraoperative neuronavigation, intraoperative neurophysiological monitoring, personalized skull base surgical access, and other modern neurosurgical assistive technologies to completely remove the tumor for the patient. “The success of this case is an important reference value for the standardized treatment of brainstem tumors.” Li Xuejun, the chief surgeon of the operation, deputy director of Hunan Province Skull Base Surgery-Neuro-Oncology Clinical Technology Research Center and associate professor of neurosurgery at Xiangya Hospital, said. “This is a typical case of comprehensive use of multiple modern neurosurgical techniques.” Associate Professor Li Xuejun said that MRI, DTI and fMRI can realize three-dimensional reconstruction of the brainstem pyramidal bundles, which can better show the relationship between the lesion and the nerve conduction bundles, and combined with the globally advanced Brainlab neuronavigation system, it can realize precise positioning and micro-invasive operation of the surgery, and Xiangya Neurosurgery Department, which has carried out intra-operative neuro-electrophysiological monitoring for more than 10 years, has already accumulated a wealth of experience,. “Under the premise of ensuring the safety of the operation, we resected the tumor lesion to the maximum extent and achieved the expected results.” After the operation, the diagnosis and treatment team carried out molecular pathology testing on top of histopathological examination according to the requirements of the latest “China Molecular Pathology Guidelines for Glioma” to provide molecular pathology evidence for the accuracy of histopathological diagnosis, provide reference for the assessment of patient’s prognosis, and provide a basis for the development of personalized treatment plan strategy for glioma after the operation. Li Xuejun pointed out that the patient in this case was diagnosed as hairy cell type astrocytoma, and good results could be obtained on the basis of adequate surgical resection. It was reported that the patient’s symptoms improved significantly after surgery and he was successfully discharged from the hospital on the 8th day after surgery. Associate Professor Li Xuejun pointed out that lesions in the brainstem region are not incurable, at present, large neurosurgery centers in China have accumulated rich treatment experience, and good results can be achieved by selecting suitable cases and adopting scientific and effective treatment means. http://www.hunanwst.gov.cn/zwxx/xjsdt1/201411/ t20141104_30128.html