The human brainstem is about the size of a thumb and accounts for only a small part of the total brain, but it has a vital importance. In terms of structure, the brainstem is located in the “center” of the brain, with the brain at the top, the cerebellum at the back, and the spinal cord at the bottom, and is responsible for the interconnection of the cerebellum, spinal cord and brain. The brainstem is where the basic centers of life are located, such as the respiratory center, heartbeat center, sleep eye center and consciousness center. Therefore, the brainstem is the central hub of the nervous system. Once there is a lesion in the brainstem, such as brainstem hemorrhage, the symptoms are often severe, causing tetraplegia, inability to swallow, eye fixation, etc. In severe cases, respiratory arrest is required to maintain life with a ventilator, and sometimes when the condition is critical, it is too late to resuscitate and death from respiratory and cardiac arrest. Therefore, in modern neurosurgery, it has long been considered that the long disease on the brainstem is inoperable and a forbidden area for surgery. However, in the past 20 years, due to the in-depth research on the anatomical function of the brainstem, together with the revolutionary development of various examination means (such as magnetic resonance), surgical equipment (such as high-definition surgical microscope, ultrasonic suction, neuronavigation, etc.), and the maturity of a new generation of neurosurgeons who have been systematically trained in microscopic neurosurgery techniques, brainstem surgery has become a relatively common operation in general provincial hospitals, and the mystery of brainstem surgery has long faded. The mystery of brainstem surgery has long faded away. The brainstem is a complex structure, housing many nuclei and nerve fibers, and just remembering the names and basic locations of these structures can make a good medical student sleepless and dreamy, but in fact, the important structures within the brainstem are not impermeable to each other, and there are “gaps” within them that can be operated on. High-definition MRI can now show the nuclei, nerve fibers, and the relationship between the lesion and these structures, so it can be used to guide the physician in deciding whether and how to operate on the lesion in the brainstem, and the neurosurgeon can already “follow the map” during surgery to remove the lesion with minimal damage to the important functional structures in the brainstem. The high-definition operating microscope and fine microsurgical instruments provide powerful tools for brainstem surgery, making brainstem surgery a basic reality. Therefore, when diagnosed with brainstem tumor, do not give up easily. When brainstem tumors are some benign lesions such as cavernous hemangioma (which is a vascular malformation rather than a real tumor), vascular reticulocytoma (also called hemangioblastoma), etc., it is more important to take a positive attitude because these lesions can be cured if the surgery is successful. For example, the author had a patient, female, 30 years old, diagnosed as medullary vascular reticulocytoma, who came to respiratory arrest due to tumor compression of respiratory center and promptly used ventilator to maintain respiration and surgical removal of tumor, after which respiration was restored, consciousness was clear and limbs moved normally, and it has been more than 4 years since the operation, and now works as normal.