Have you ever heard of smoker’s disease? It used to be said to be a rare and untreatable disease. Many people are unfamiliar with smog. When you hear the name, you may associate it with a disease that is not caused by smoking. So is this actually the case? 1. What is smog, and is it related to smoking? Smog is a disease that people think is not caused by smoking, but in fact it has nothing to do with smoking. Smoke disease, in fact, is a cerebrovascular disease, was first discovered by a Japanese professor in the 1950s. Specifically, it is a gradual occlusion of the arteries at the base of the skull, followed by the formation of an abnormal vascular network to compensate for the lack of blood supply caused by the occlusion of the arteries. This anomalous vascular network is like a smoke-like. Therefore, this cerebrovascular disease is called smog disease. Therefore, it is a different concept from the common people’s understanding of smog. In general, the first thing that happens is that the end of the carotid artery in the anterior circulation starts to gradually occlude. This is followed by the formation of an abnormal vascular network. The middle cerebral artery and the anterior cerebral artery are also progressively occluded. Such a disease is smog. 2. How can we see the formation of this abnormal blood vessel network? The abnormal blood vessels are invisible to the naked eye because they are in the intracranial part of the brain. In the past, when imaging was not developed, it could not be detected. Now we have a test called cerebral angiography, which can be used to detect the abnormal blood vessels through a contrast agent and continuous filming of the trajectory of the vessels through which the contrast agent passes, and through electronic computer-aided imaging, we can dynamically detect the abnormal blood vessels, which are a messy mass of blood vessels like capillaries. From its morphology, it looks like a smoke-like vessel, and these abnormal vascular networks are also called smoke-vessels. 3. How are smoky blood vessels formed? There are four blood vessels in our body going to the brain. The front two vessels are called the anterior circulation vessels, the carotid arteries bilaterally; the back has the vertebral artery system. This smoker’s disease is a lesion of the anterior circulation vessels, that is, the bilateral distal carotid arteries gradually begin to occlude. Then, there is an anterior cerebral artery and a middle cerebral artery at the distal bifurcation of the carotid arteries. This area also gradually begins to occlude. After the occlusion, there is a lack of blood supply to the brain. Our brain is very smart, it has a self-regulating mechanism, in order to compensate for this lack of blood supply, it forms a what? It forms a lot of capillary-like abnormal blood vessels that are different from normal people, and these abnormal blood vessels take on a smoky form, which is called smoke vessels.