Pineal tumor accounts for 1-8% of intracranial tumors, and most of them are accompanied by hydrocephalus. Patients are often found to have pineal tumor only after further examination due to secondary hydrocephalus. However, the right ventriculoperitoneal shunt surgery (whether it is a lateral ventricular frontal horn shunt or occipital horn shunt) occupies the surgical incision for later resection of tumor, because the commonly used surgical approach for pineal tumor is POPPEN (right occipital craniotomy) and right frontal craniotomy via intercallosal fornix approach. The reason for the title question is that recently, the pineal area tumor surgery has been performed through the right occipital opening (POPPEN) and the right frontal opening through the intercallosal vault. The reason for this question is that in the last 2 weeks, 3 patients with pineal tumor had right ventriculoperitoneal shunt surgery in local hospital due to hydrocephalus, 2 cases were right frontal and 1 case was occipital angle, although the tumor was fully resected by left frontal craniotomy via intercallosal fornix approach, the operation was very difficult on the left side, which in effect further increased the difficulty of surgery.