The human brainstem is only about the size of a thumb, but it is the center of human life and is closely related to human life, so any “failure” is enough to make people talk about it. Brainstem: the central hub of the nervous system The brainstem is at the “center” of the brain, with the brain at the top, the cerebellum at the back, and the spinal cord at the bottom. It is responsible for the interconnection of the cerebellum, the spinal cord and the brain. It is also the entry and exit point of all brain nerves except for the olfactory and optic nerves. In addition, the respiratory center, the heartbeat center, the sleep-eye center and the consciousness center are all located in the brainstem. Therefore, the brainstem is the central hub of the nervous system and is the basic center of life. Brainstem surgery: can be carried out Once there is a lesion in the brainstem, such as brainstem hemorrhage …… and other diseases often cause symptoms such as tetraplegia, inability to swallow, eye fixation, etc. In severe cases, breathing stops and a ventilator is needed to maintain life. There are even critical conditions when it is too late to resuscitate patients who have died because of respiratory and cardiac arrest. Therefore, neurosurgery has long considered the brainstem as a restricted area for “surgery”. However, in the past 20 years, with the in-depth study of the anatomical function of the brainstem, coupled with the revolutionary development of various examination means (such as magnetic resonance), surgical equipment (such as high-definition surgical microscope, ultrasonic suction, neuronavigation, etc.), and the maturity of a new generation of neurosurgeons who have been systematically trained in microscopic neurosurgery techniques, brainstem surgery has become a relatively common operation in general provincial hospitals, and the mystery of brainstem surgery has faded away. The mystery of brainstem surgery has also faded away. The brainstem is a complex structure that houses many nuclei and nerve fibers, and just remembering the names and basic locations of these structures can make a good medical student sleepless and sleepy. But in fact, the important structures in the brainstem are not impermeable to each other, and there are “gaps” within them that can be operated on. High-definition MRI can now show the nuclei, nerve fibers, and the relationship of the lesion to these structures, which can be used to guide the surgeon in deciding whether and how to operate on a lesion in the brainstem. The neurosurgeon can also “follow the map” during surgery to remove the lesion with minimal damage to the important functional structures in the brainstem. The high-definition operating microscope and fine microsurgical instruments provide powerful tools for brainstem surgery, making brainstem surgery a basic reality. Benign brainstem tumor: curable There was a female patient, 30 years old, who was diagnosed with medullary vascular reticulocytoma. At the time of consultation, respiratory arrest occurred due to tumor compression of the respiratory center, and the hospital promptly used a ventilator to maintain the patient’s breathing and surgically removed the tumor. After the operation, he recovered breathing, became conscious and had normal limb movement. It has been more than 4 years since the operation and he is now working like a normal person. Therefore, when diagnosed with brainstem tumor, patients should not give up easily. When the brainstem tumor is some benign lesions such as cavernous hemangioma (a vascular malformation rather than a real tumor), vascular reticulocytoma (also called hemangioblastoma), etc., it is more important to take a positive attitude, because these lesions can be cured if the surgery is successful.