A baby girl in Jiangsu has a hole in her skull due to a congenital developmental defect, with brain tissue hanging down into the nasal cavity and cerebrospinal fluid flowing out of the nostrils. Experts say that the surgery is currently very difficult. This child’s disease is called “meningeal bulge” or “meningeal brain bulge”, which is caused by abnormal embryonic development, often combined with other craniofacial and brain developmental abnormalities. This congenital malformation is not very rare. The child in the news had a “runny nose,” or “cerebrospinal fluid leak,” which is a red flag. Cerebrospinal fluid is the fluid that nourishes and protects the brain and normally does not flow outside the cranial cavity. If there is a cerebrospinal fluid leak, it means that there is a breach in the cranial cavity, and bacteria in the environment can easily invade the brain and cause severe meningitis and/or meningoencephalitis, which can be life-threatening. Aggressive surgery is currently the best and only way to treat this child. But the risks of surgery in newborn infants are indeed quite high, and such risks are several or even a dozen times higher than for surgery in childhood. The surgical treatment of this disease is technically demanding and is one of the most difficult surgeries in the specialty of neurosurgery (brain surgery) and pediatric neurosurgery, which belongs to the most cutting-edge skull base surgery. According to our years of experience, there are two extremely important steps in this type of surgical treatment besides intoxication, the first is how to protect the brain from damage, and the second is how to repair the defective meninges and skull. The latter determines the success of the surgery, while the former is crucial to the child’s ability to maintain normal brain function and quality of life later on.