Acute cerebrovascular disease, also known as stroke, is a serious health hazard with high morbidity, mortality and disability rates. Stroke is divided into ischemic stroke and hemorrhagic stroke, of which ischemic stroke accounts for more than 70%, so the following section focuses on ischemic stroke. There are many ways to classify ischemic stroke, including the anatomical localization of blood vessels and clinical manifestations: complete anterior circulation cerebral infarction, partial anterior circulation cerebral infarction, posterior circulation cerebral infarction, and lacunar cerebral infarction, i.e., OSCP typing. Some classify cerebral infarction into: complete stroke, progressive stroke, and reversible ischemic stroke attack according to the form of onset and course of disease. Some are classified according to the pathogenesis: atherosclerosis-shaped thrombosis, cerebral embolism, lacunar cerebral infarction and watershed infarction. The infarct size is divided into: large cerebral infarction (occupying a lobe or infarct diameter greater than 5 cm) medium cerebral infarction (diameter 3.1-5 cm) small cerebral infarction (diameter 1.6-3 cm) lacunar cerebral infarction (diameter below 1.5 cm). From an etiological point of view, the classification of ischemic stroke into large atherosclerotic, cardiogenic, small vessel, other causes, and unknown causes was proposed by Toast as early as 1993. More recently we have had our own CISS typing. We say that the above typologies are from different perspectives, but some of them are unscientific and can cause confusion in treatment, and many lazy doctors will not bother to further analyze and search for the real cause. We still advocate etiological classification because any treatment and research that is not guided by etiology cannot solve the problem at its root. I often see patients and family members ask doctors, “Why did I die of a brain infarction?” The doctor replied, “Because you have high blood pressure, high blood pressure, diabetes, etc.” Then the patient said, “My blood pressure, blood sugar, lipid control are very good, I also do not smoke, good lifestyle habits, how can I still get the disease? The doctor is speechless. In fact, this doctor can not distinguish the cause, risk factors, pathogenesis, and confuse them all. For example: for example, a person has high blood pressure, diabetes, high blood fat (risk factors) → caused atherosclerosis (cause) → lead to arterial stenosis with unstable plaque off caused by arterial to arterial brain embolism (pathogenesis). Then we only know the cause of this disease, combined with the risk factors and pathogenesis of this patient for risk stratification to guide our treatment, such as intensive lipid lowering and plaque stabilization, dual antiplatelet and so on. Similarly, if this patient’s imaging suggests cerebral infarction in the junctional area, then it may be a combination of decreased embolic clearance (pathogenesis) on top of hypoperfusion, and then we should add volume expansion to improve perfusion on top of the above treatment. If a patient has atrial fibrillation (risk factor) → causes a cardiogenic cerebral embolism (etiology) then we need to anticoagulate. If a patient has a stroke due to smog, then it is surgical treatment that is needed to solve the problem. So it is not reasonable to have one treatment plan no matter what the patient is. This is especially true for neurologists. Many people think that it is easy to be a neurologist, isn’t it just three elements (hormones, vitamins, antibiotics) and one soup (dehydration and rehydration)? In fact, if we do not investigate the cause of such a patient, but only treat the symptoms, his symptoms and signs may be temporarily relieved, but the underlying cause is not solved, it will be repeatedly stroke, and we know that each stroke will leave some symptoms and signs, so the final result of repeated attacks is that the patient may be bedridden, unable to take care of themselves, dementia, vegetative state survival. This is a heavy burden to the family and society. Although medical knowledge is not as fast as the electronic science update, but with the emergence of new technologies, new detection means many traditional concepts are now proven to be unscientific, and some are even completely wrong. As clinicians, we should not think that we have mastered all the knowledge after learning bachelor’s, master’s and even doctoral degrees, but we should still keep updating our knowledge, learning is not an overnight process, it is a continuous process, if we cannot keep learning we will eventually fail to keep up with the development of the times and be eliminated, because the wrong theory-guided practice can you think right? Can patients benefit? In addition, there are specialties in studies and specialties in the field. Behind a seemingly simple cerebral infarction there are many, many problems that are difficult to experience so profoundly without a specialist, so specialist treatment is necessary. As a small doctor in neurology, I have to continuously strengthen my study, enrich myself, and be responsible for myself and my patients, which I think is probably the greatest medical ethics.