11-year-old girl with intermittent right-sided limb numbness and hypertension. Diagnosis: smoker’s disease. Also known as: skull base anomalous vascular network sign. Superficial temporal artery frontal branch-middle cerebral artery bypass and superficial temporal artery parietal branch patching were performed. Intraoperative showed patency of the bypass vessel, confirmed by ultrasound. The postoperative recovery was good, and CTA: the bypass vessels were poorly visualized.