In a declaration, it means it's a pointer to a pointer:
int **x; // declare x as a pointer to a pointer to an int
When using it, it deferences it twice:
int x = 1;
int *y = &x; // declare y as a pointer to x
int **z = &y; // declare z as a pointer to y
**z = 2; // sets the thing pointed to (the thing pointed to by z) to 2
// i.e., sets x to 2
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