Children under the age of 10 are one of the most prevalent age groups for smog, and we have treated many very young children with smog who have recovered very well from surgery. A large percentage of these children have come to us after unsuccessful attempts at local hospitals or other major hospitals. Why is it more difficult to treat such children with smog? The blood vessels of children with smog are very thin and fragile, and the cerebral blood vessels of young children are even more delicate, about 1 mm, making vascular anastomosis quite difficult. Moreover, the blood volume of such a small child is very low, so it is even more important to control and reduce bleeding during surgery, and intraoperative anesthesia management, blood pressure management, and postoperative perioperative management are all very important. In the face of these problems, our team has overcome the difficulties in this area and has successfully made a breakthrough in the surgery of young children with smog disease. It is also important to choose the specific type of surgery to be adopted for treatment. Combined vascular bypass surgery, while directly bypassing the brain to rapidly improve blood supply and prevent recent cerebral infarction, also performs multifactorial patching on the brain surface to induce the formation of neovascularization and further expand the scope of blood supply improvement, with a two-pronged approach to achieve better treatment results. Moreover, the patching in our combined vascular bypass surgery is different from the previous temporal muscle patching, but multi-factor patching, the patching factors include temporal muscle, dura mater, cranial periosteum, middle meningeal artery, etc. The patching scope covers the temporal lobe, parietal lobe, frontal lobe and part of occipital lobe of the brain, which can expand the patching scope to the frontal lobe, which is one of the advantages of combined vascular bypass surgery, because the frontal lobe is closely related to human cognition, intelligence and emotion, etc. This is an advantage of combined vascular bypass surgery because the frontal lobe is closely related to human cognition, intelligence and emotion, so it is very beneficial to the intellectual development and recovery of patients, especially children. Clinical practice has shown that a good blood supply can be achieved by re-establishing adequate and complete blood bypass channels for the child through combined vascular bypass surgery. In this way, the brain gets sufficient blood supply, all neurological functions operate normally, the whole person recovers a good health state, and the normal growth and development of the child including intelligence can be unaffected. Our team has treated more than 100 children with smog, the youngest of whom was a 1-year-old child.