The patient, Zhang ××, female, 42 years old, consulted local hospital for recurrent headache for 2 months, and again the head CT found a ventricular tumor and transferred to our hospital, and the cranial MRI examination showed that the size of the tumor in the right lateral ventricle was about 4.5×4.0×3.5cm, and the meningioma was considered, and surgery was proposed. After admission, physical examination: clear, painful expression, sensitive pupillary light reflex, normal eye activity, no visual field defects, no abnormal heart, lung and abdomen, limb muscle strength grade V, negative pathological signs. 2, preoperative imaging examination After admission, the cranial MRI enhancement scan was perfected, which showed that an oval long T1 iso-T2 signal was seen in the right ventricular triangle, with a size of about 4.5×4.0×3.5cm, clear border and relatively homogeneous signal, and the lesion was obviously and uniformly strengthened in the enhancement scan, but no abnormal strengthening was seen in the rest of the scan. The patient was considered to have a meningioma combined with hydrocephalus. The tumor was found to be gray-red, with smooth surface and clear border, and the blood supply artery was located at the bottom and the posterior medial choroidal artery. The residual tumor was completely removed. After the operation, the skull was closed and no drainage tube was left in place. Postoperatively, hemostasis and anti-infection treatment were routinely given, and mannitol was not used for dehydration. The incision healed well and the stitches were removed 8 days after surgery. 4. Treatment results After surgery, the patient was awake, with no restriction of limb movement, sensitive light reflexes such as bilateral pupils, normal eye movement, no visual blur and visual field defects. The patient was discharged from the hospital 11 days after the operation. At the time of discharge, he was clear, thinking normally, with good movement of the limbs and walking freely. Postoperative imaging examination: 10 days after surgery, the cranial CT was repeated and showed that the huge tumor in the right ventricle was completely resected. Meningioma is a common intracranial primary tumor, second only to glioma, which accounts for 19.2% of primary intracranial tumors at home and abroad. Meningioma can occur in all parts of the nervous system, and most intracranial meningiomas are located in the convex surface of the brain adjacent to the sagittal sinus and falx cerebri, accounting for about 50%, while intracerebral meningiomas are less common, accounting for about 1-2%. Intracerebroventricular meningioma mostly occurs in the choroid plexus fissure in the lateral ventricular triangle, with common symptoms such as headache, personality changes, visual impairment, and weakness of limbs. The tumor is often supplied by the internal carotid artery, posterior cerebral artery and choroid plexus artery. This case is an intracerebroventricular meningioma with a huge tumor. The reasons for the surgical difficulties are as follows: a. The tumor is huge and rich in blood supply, so it should be excised in pieces, so there is a lot of intraoperative bleeding, and if it is difficult to stop bleeding, the operation will take a long time, and hypovolemia or even shock will easily occur, which will affect the complete excision of the tumor; b. The tumor is large, so it is difficult to reveal the tumor during the operation, and a wide range of incision is needed, which may cause cerebral cortex dysfunction. The main experience of this case includes: Ⅰ, surgical approach selection: according to the size and location of the tumor, choosing the best surgical approach is a prerequisite for complete resection of the tumor, and in this case, the locked-hole technique was used, which caused very little damage and avoided the nerve loss brought by the surgery. It is advisable to perform block resection to gradually hollow out the center of the tumor and gradually collapse the tumor body, thus reducing the requirement for traction, and through block resection, the deep structure can be gradually revealed to facilitate the treatment of deep or dorsal tumor donor vessels; IV. V. In this case, the locked-hole technique was used, and no drainage tube was placed after surgery, so the chance of infection and rebleeding was small.