Smog is a cerebrovascular disease that was first discovered and named by Japanese medical experts in the 1950s. However, with the development and popularization of medical imaging technology in recent years, many local primary care hospitals are able to perform relevant cerebrovascular imaging examinations, so the detection and incidence of smog disease has gradually increased in recent years. This also poses a more difficult task and challenge for the neurosurgical community to treat smog disease in a timely and correct manner. The age of onset of smog disease is bimodal, mainly in adults around 40 years old and children under 10 years old. If smog occurs in children, it can have a huge impact on the growth and health of the child, whether it is on intellectual development, physical development, speech, movement, behavior, etc. Therefore, surgery should be performed in time to avoid this harm. So, some patients ask what are the sequelae of surgery for smog in children? There are different surgical treatments for smoldering disease. An academic paper titled “Treatment and medications for smog” published on the pediatric neurology channel of a U.S. physician’s continuing education website provides a review of some of the surgical procedures that have been used in the history of smog treatment: Historically, several surgical procedures have been used in the treatment of MMD, such as STA-MCA anastomosis (bypass), dural artery applanation (EDAS), dural artery muscle patch (EDAMS), soft membrane patch, and omental implant. In fact, the two main types of procedures he reviewed are direct vascular bypass and patching. However, clinical practice has shown that both direct vascular bypass and patching alone have some defects and shortcomings, which do not achieve ideal results, such as the limitation of direct vascular bypass to improve the scope of learning, such as the slow onset of action of patching alone. At present, a more advanced and ideal surgical method is combined vascular bypass surgery, which is to combine direct vascular bypass surgery and patching surgery in the same surgery, so that the two-pronged approach can jointly establish a more perfect bypass blood supply system for the patient’s brain and greatly improve the brain blood supply, thus achieving good treatment results. When children with smog are treated well by combined vascular bypass surgery, there are usually no after-effects.