In recent years, the incidence of cardiovascular and cerebrovascular diseases has gradually increased, becoming a major threat to human life and health. One of the rarer cerebrovascular diseases, which can cause serious consequences, is smog disease. Many people may not know much about this smog disease, and even some primary care workers have never heard of it. It is no wonder that, as a rare disease, it has a very low incidence and many primary care providers may not have come into contact with such cases. Smoker’s disease, is named from the morphology of the blood vessels in the brain. It is mainly a narrowing or occlusion of the main cerebral arteries, resulting in impaired blood supply to the brain, which then triggers compensatory hyperplasia of the penetrating arteries at the base of the brain, forming a network of tiny, fragile, smoky, malformed small vessels. The wall of this abnormal hyperplastic smoky vessel is very thin and fragile, which can easily rupture and lead to cerebral hemorrhage. If left untreated, it may also bleed again. Then some patients ask what will happen if there is a second hemorrhage in smoldering disease. That would be very dangerous, and the mortality rate of secondary bleeding would be greatly increased and easily life-threatening. Therefore, patients with smog disease should undergo surgery in time to avoid brain hemorrhage before it occurs. The most effective surgical treatment for smog is combined vascular bypass surgery. Combined vascular bypass surgery can re-establish a good blood supply bypass for the brain at the level of both main blood vessels and skull base vascular network through the dual procedure of direct bypass + patching, which can fully and comprehensively improve the blood supply to the brain and greatly reduce the incidence of cerebral ischemia and cerebral infarction. At the same time, the blood supply is improved, then the compensatory smoldering vascular phase will slowly disappear, effectively preventing the occurrence of cerebral hemorrhage.