The patient was a middle-aged female, 46 years old, admitted to the hospital with the chief complaint of “sudden headache with blurred vision in the right eye for more than 4 months, 15 years after cholesteatoma surgery”. The patient was admitted to the hospital on December 10, 2014 with the following complaints: blurred vision in both eyes since 15 years ago, no obvious change in visual field, and sudden syncope with no obvious cause, of unknown duration. He was then referred to the Shanxi Provincial People’s Hospital for surgery. Four months ago, the patient developed intermittent headache without any obvious cause, located in the right frontotemporal area, with irregular duration and frequency, accompanied by blurred vision in the right eye, and no limb or activity disorder. On December 2, 2014, in Shanxi Provincial People’s Hospital, a cranial MRI was performed to suggest: 1. postoperative changes of cholesteatoma in the saddle area; irregular long T1 low signal and long T2 high signal shadows were seen in the bottom of the frontal lobe, left medial temporal, pterygoid saddle, suprasellar pool, interpeduncular pool, and anterior pontine pool bilaterally, and diffusion-weighted images showed high signal shadows with a maximum meridian of about 3.8cm*4.8cm*4.9cm. for further surgical treatment came to The patient was admitted to our hospital as an outpatient with “cholesteatoma of the saddle area”. At the time of admission, the patient had a clear consciousness, acceptable mental diet, normal night sleep, and normal bowel movements. He was physically fit in the past. On admission to the hospital, he had a 15-cm coronal incision on his forehead and abnormal double vision on gross examination. The rest of the referral examination did not show any abnormality. The ophthalmology consultation was requested to perform visual field examination. The left eye was exotropic, the pupil size was about 6mm, the visual acuity of the right eye was about 0.8, the left eye had no light perception and bilateral optic nerve atrophy, and the right visual field was partially deficient. He was admitted to the hospital and underwent surgery under general anesthesia after completing relevant examinations. After perfecting the preoperative examination, the surgery was performed on December 16, 2014 under general anesthesia for the left enlarged pterygopoint approach to the saddle area and left temporal and anterior pontine pool cholesteatoma, and the surgery went smoothly. The visual field of both eyes did not change significantly from that before surgery. Postoperative reexamination of cranial CT suggested that a small amount of bleeding was visible in the operative area. The patient continued to be treated with routine cerebral surgery infusion, and the patient’s vital changes were observed. During the hospitalization, lumbar puncture was performed and part of the hemorrhagic cerebrospinal fluid was replaced, and the cerebrospinal fluid was monitored for routine biochemical and other tests. On December 30, 2104, the patient had a clear consciousness, good mental diet, good night sleep, no special discomfort, and stable vital signs. There was no significant change in visual acuity in both eyes. The intracranial hemorrhage had been completely absorbed as seen in the cranial CT review. The patient and his family were satisfied with the treatment and requested to be discharged. A recent follow-up telephone call revealed that the patient had recovered well after surgery, and a visit to the local hospital suggested that no recurrence of cholesteatoma was seen in the operated area.