Cerebral leukomalacia is a structural alteration of the brain, characterized mainly by damage to the myelin sheath of central nerve cells, with lesions involving mainly the white matter tracts of higher brain functions. Its clinical manifestations range from inattention, forgetfulness and personality changes, and emotional disturbances. The persistent development of lesions can mostly develop into brain atrophy, dementia, coma, etc., and even death. The medical science classifies white matter lesions into various types according to the cause of occurrence. For example: (1) toxic leukoencephalopathy (also called diffuse leukoencephalopathy) is a leukoencephalopathy caused by a variety of toxic factors: such as certain antineoplastic drugs, antibiotics and immune agents; drugs of abuse, such as toluene, ethanol, heroin, etc.; and environmental toxins. Among these factors, cranial irradiation and antineoplastic chemotherapy are very definite causes of toxic cerebral leukomalacia. (2) Radiotherapeutic leukoencephalopathy is due to the degree of neurotoxicity caused by cranial irradiation, which is related to the total dose received, the duration, the dose-fractionation scheme and the volume irradiated. Irradiation-induced cerebral leukomalacia is divided into 3 phases, namely the acute response phase, the longer-lasting delayed response phase, and the severe delayed response phase. In the acute response phase, the white matter of the brain shows patchy reversible edema; in the more prolonged delayed response phase, extensive edema and demyelination of the white matter occur; and in the severe delayed response phase, cerebral vascular necrosis and thrombosis occur, resulting in loss of myelinated axons. (3) Chemotherapeutic leukoencephalopathy: With the increase of chemotherapy intensity and drug dose, the number of reports of chemotherapy-induced cerebral leukoencephalopathy has gradually increased. Some clinical antitumor chemotherapy drugs such as cisplatin, cytarabine, fluorouracil, carmofur, levamisole, methotrexate, fludarabine, cetapide, carmustine, and isocyclophosphamide can cause cerebral leukomalacia, among which methotrexate, carmustine, and cisplatin are the most common. The neurotoxicity caused by chemotherapy is related to the route of administration, dose and method of administration, and the combination of chemotherapy drugs and cranial irradiation is more harmful and should be given sufficient attention. For the prevention and treatment of cerebral leukodystrophy, it is generally believed that the condition of most patients with cerebral leukodystrophy can be controlled. However, it is more difficult to treat cerebral white matter lesions or cerebral white matter deformation in elderly people. In the treatment, the possible etiology should be analyzed to get rid of the possible causative factors. After that, a combination of appropriate brain metabolic support drugs, antioxidant drugs and neurocytoprotective agents should be taken. From the clinical point of view, as long as the diagnosis is clear, the analysis is comprehensive, and the measures are effective, together with the appropriate combination of patients, a relatively good therapeutic effect can generally be achieved. At the same time, if the treatment can be based on the diagnosis of Chinese medicine, together with Chinese medicine, the effect will be better and faster!