First, it is important to know that cerebrovascular disease is a lesion of brain tissue due to cerebrovascular disease from any cause. If the disease starts acutely, it is also called acute cerebrovascular disease, stroke or stroke. Acute cerebrovascular disease includes (1) ischemic cerebrovascular disease caused by narrowing or blockage of blood vessels; (2) hemorrhagic cerebrovascular disease caused by rupture of blood vessels. Hemorrhagic cerebrovascular disease includes cerebral hemorrhage (commonly known as cerebral hemorrhage) and subarachnoid hemorrhage. Ischemic cerebrovascular disease includes transient ischemic attack and cerebral infarction, which is also called cerebral infarction, commonly known as “cerebral infarction” and “cerebral thrombosis”, and transient ischemic attack is the precursor of cerebral infarction. Cerebral infarction is caused by many reasons, and the treatment and future preventive measures are different for different causes. Therefore, the diagnosis of cerebral infarction is only the first step, and those who are able to do so are advised to undergo further examination to try to clarify the cause and assess the risk factors in order to provide more targeted treatment and prevent recurrence. The causes of cerebral infarction are divided into five categories (1) large atherosclerosis, which refers to the formation of thrombus in large intracranial and extracranial vessels on the basis of atherosclerotic plaque, causing stenosis or blockage of blood vessels. (2) Cardiogenic cerebral embolism, which refers to the dislodgement of thrombus formed in the heart and blockage of cerebral vessels with blood flow. Common causes include atrial fibrillation, rheumatic heart valve disease, post-prosthetic heart valve replacement, acute myocardial infarction, cardiomyopathy, etc. (3) Small vessel disease, which refers to the blockage of small arteries in the brain by sclerosis and narrowing. Common causes of small arteriosclerosis include hypertension, diabetes mellitus, and advanced age. (4) Other rare causes, accounting for only about 5%, such as vasculitis, vascular entrapment, hereditary cerebrovascular disease,, blood disorders, drug addiction, etc. (5) The cause is unknown. Cerebrovascular disease examination (1) brain CT, preferably with brain magnetic resonance imaging (MRI); (2) blood routine, blood biochemistry, coagulation function, to understand the basic situation of blood; (3) risk factors assessment, such as blood pressure, blood glucose, blood lipids, blood uric acid, blood homocysteine; (4) cerebrovascular assessment, such as cervical vascular ultrasound, TCD, is relatively inexpensive and non-invasive, and can be used as a routine cerebrovascular disease screening, and then depending on the situation, decide whether further tests such as magnetic resonance angiography (MRA), CT angiography (CTA), cerebral angiography, etc. are necessary. (5) Cardiac evaluation, such as electrocardiogram, and then decide whether further tests, such as 24-hour electrocardiogram, cardiac ultrasound, etc., are necessary depending on the situation. (6) Other special tests, such as cerebral perfusion assessment, cerebral blood flow and microembolism monitoring for those with vascular stenosis, hereditary vascular disease may require relevant enzyme activity, skin biopsy, genetic examination, etc. It should be scientifically recognized that despite the tests, a small number of patients still fall into the category of cerebral infarction of unknown origin. In my opinion, the doctor’s duty is – to conduct targeted examination and evaluation for each patient, to try to help the patient identify the cause, and to carry out targeted treatment and recurrence prevention measures, and this is where the level of diagnosis and treatment of cerebrovascular disease varies from hospital to hospital. Not all patients undergo the same tests across the board, and the decision needs to be considered by your doctor based on your condition. It is important to be thorough and to consider what the patient can afford.