Is there unilateral and bilateral smoker’s disease? Smoker’s disease is classified as unilateral or bilateral. Generally speaking, smog is a bilateral cerebrovascular abnormality, but there are a few cases that are unilateral. Does unilateral mean that the risk is reduced by half and is not as serious? Of course not. Smoker’s disease is a serious cerebrovascular disease. While the brain is divided into left and right brain, accordingly, the cerebral blood vessels are symmetrically distributed in the left and right brain. Under normal circumstances, the various functions of the body are governed by the opposite side of the brain, so neither side of the brain can be missing. Unilateral smoker’s disease can also cause cerebral ischemia, resulting in unilateral limb weakness and numbness, and in severe cases, it may lead to hemiplegia of one limb and may even be life-threatening. So its risk index is comparable to bilateral. Patients should not take it lightly. Whether it is unilateral or bilateral smog, it is a very serious disease. Therefore, once smog is diagnosed, whether it is unilateral or bilateral, surgery should be performed as soon as possible to remove the hidden danger. Currently, the most advanced surgical treatment for smog in China is combined vascular bypass surgery. The surgery can establish a more extensive and comprehensive blood flow to the brain, which can provide better blood supply and has excellent treatment effect for patients with smog. How is unilateral and bilateral smog treated? The treatment for unilateral and bilateral smog is the same. The only difference may be that the surgery only needs to be done on one side and does not have to be performed in two separate surgeries, reducing pain and financial stress for the patient. The surgery can be performed as a stand-alone treatment or in combination. Direct revascularization (bypass) is one of the surgical procedures with fast results after surgery, which can improve cerebral hemodynamics immediately after surgery, but the improvement of ischemia is limited; it is more difficult for pediatric patients with fine blood vessels and is suitable for adults. Indirect revascularization (patching) procedure takes 3~4 months to form neovascularization and induce neovascularization production, and is suitable for children with strong vascular rebuilding ability; for adults with poor vascular regeneration ability, there is a 40%~50% failure rate. The risk of smoldering disease may still occur during this three-month period. Combined vascular bypass (bypass) is a new procedure combining direct and indirect revascularization, which was introduced from Japan and improved and optimized in China for many years, and is one of the procedures with fast results. While using bypass to rapidly improve the ischemic site, patching is used to form neovascularization, which further expands the area of ischemia being improved. It also solves the risk that the patching procedure takes a long time to induce the formation of new blood vessels and that accidents may occur during this time. It is the most recommended treatment for smog.