Everyone is afraid of getting sick, but there are always some diseases that happen quietly and pose harm to people both physically and psychologically. Smog is a rare abnormal cerebrovascular disease of the skull base that affects the blood supply to the brain and can lead to cerebral infarction and hemorrhage if left untreated. In clinical practice, the high prevalence of smog is in children under 10 years of age and adults around 40 years of age, and there are two main types of symptoms in smog, one is cerebral ischemia and one is cerebral hemorrhage. When smog causes a patient to have inadequate blood supply to the brain, some proliferating compensatory vessels appear at the base of the skull and brain. Does smog disease with compensations need surgical treatment? This is a question that many patients have asked, but it is important to point out that smog is a progressive disease and there is a risk that the disease will worsen and deteriorate. Even though some patients have well-developed compensated vessels, this does not mean that the blood supply to the brain can be adequately ensured and there is a possibility of deterioration. Therefore, it is important that patients do not always take a chance and go to the hospital for immediate treatment. In the treatment of smog, it has been clearly stated that there is no specific drug available and that surgical revascularization should be performed intracranially and extracranially to effectively prevent and treat ischemic strokes.