1.What is crestal ventricular meningioma? Ventricular meningioma of the crestal medulla originates from the ventricular meningeal cells of the central canal of the crestal medulla and grows in an expansive manner, mostly in the cervical or cervicothoracic segments. Ventricular meningioma is the most common intramedullary primary tumor of the crista medullaris in adults. 2. Is crestal ventricular meningioma benign? Most of the tumors have distinguishable boundaries with normal crestal medullary tissues, and cystic changes can be seen at both ends of the tumor. 3.Treatment status? Microsurgery to remove the tumor is the first choice of treatment, and most of them have good treatment effect. However, due to the concern of patients and their families about the complications and efficacy of this disease, as well as the difference in surgical techniques of surgeons, it leads to the delay of treatment for treating patients, who come back to the clinic with paralysis and other conditions and regret. 4.Treatment experience In view of these realities, I would like to share my experience of nearly 2000 cases of intramedullary tumors for more than 20 years in crestal medullary tumors as follows. (1) Tumor is small and asymptomatic treatment. If the tumor is small, detected by chance and without any symptoms, you can review MRI every six months to dynamically observe the tumor changes. If the tumor does not change, it can still be observed; if it grows bigger and symptoms appear, surgery should be considered; if it becomes smaller, there is a possibility of misdiagnosis, so it is necessary to re-establish the diagnosis and treatment plan and review it regularly. (2) Smaller tumor with symptoms. Many doctors and patients are reluctant to operate because most of the symptoms are mild and will be aggravated after surgery and new symptoms are added. I believe that surgery should be performed, and it is difficult to predict whether it will aggravate the nerve damage. (3) Large tumor with no symptoms or mild symptoms I have encountered so many patients who are reluctant to operate and have catastrophic events such as tumor bleeding, paralysis, etc. months or six months later. Therefore, prophylactic surgery should still be clear with the patient. (4) High cervical medullary, risky tumors Most of them are more symptomatic, whether to operate or to give up should be communicated well, most of the patients’ families report that they are hopeful and willing to operate. However, it mainly depends on the surgical technique of the surgeon.