Smoker’s disease is a relatively rare cerebrovascular disease, which can have two main harmful symptoms. One is that it may cause a series of cerebral ischemic symptoms or even cerebral infarction, and the second is that it may lead to cerebral hemorrhage, mostly intraventricular or subarachnoid hemorrhage. Both of these are very dangerous. Let’s start with cerebral hemorrhage, which usually has little aura and a sharp onset, often with a severe headache, the latter with sudden weakness of the limbs to the point of syncope. This is very serious and may even lead to disability or death. Then there is cerebral ischemia, and in severe cases, cerebral infarction. Depending on the area of ischemia or infarction, the symptoms can vary. If the infarction is in the motor function area of the brain, it may manifest as weakness of limbs and unfavorable activities; if it affects the visual function area, it may lead to loss of vision, visual field defects, blurred vision, etc.; and if the infarction or damage is in the speech function area, it may manifest speech impairment, inability to speak or slurred speech, etc. Some patients ask how to treat smog when they can’t speak. In fact, regardless of the symptoms of smoker’s disease, the treatment is basically the same, that is, to reconstruct the cerebral blood flow and provide sufficient blood supply to the brain. This can only be accomplished by surgical means, which cannot be achieved by conservative internal medicine. Currently, combined vascular bypass surgery is a very effective surgical procedure for the treatment of smoker’s disease. Combined bypass surgery is a dual procedure in which direct bypass and patching are done in the same surgery. The direct bypass rapidly improves the blood supply to the main vascular channels, while multifactorial patching is performed on the brain surface to induce the formation of new blood vessels and expand the scope of blood supply improvement.