In patients with cerebral hemorrhage, how to apply imaging to assess whether the patient continues to bleed. We performed a study that used a point sign to assess if there was a bleeding point that predicted that their hematoma would expand. We defined re-expansion of the hematoma as an enlargement of more than 30% of the original size. The results will be better if the point sign is added together with the analysis based on morphology and internal signals. The identification of punctate signs depends on experience, not the punctate signs, but the thickening of blood vessels and the rupture of blood vessels. A decade ago, a very popular study in the international neurology field was the ischemic semidark zone around the hematoma, but because of two very different opinions and evidence, this study was not concluded. However, because of the emergence of two very different opinions, both with evidence, the research in this area was left unresolved. The prognosis of patients with clinical type I, type II, or type III is evaluated in the context of point signs and should be treated differently, i.e., individually. Both acute cerebral infarction and acute cerebral hemorrhage have their own different pathophysiological mechanisms, which are manifested in imaging and show different signs. We can make a comprehensive assessment of the disease progression and prognosis based on imaging manifestations, together with other symptoms and signs, which can guide us to implement individualized treatment in clinical practice, further improving the prognosis of stroke patients and reducing their mortality and disability rates. The internal carotid artery system supplies blood flow to most of the cerebral hemispheres. As we age, plaque formed by cholesterol, calcium and fibrous tissue gradually appears within the arterial wall. As the plaque gradually increases, the artery becomes narrowed or occluded. This process is called atherosclerosis. Once the plaque is dislodged, it will block the blood vessels in the brain, causing ischemic stroke, limb dysfunction, or other neurological dysfunction. Internal carotid artery endothelial debridement is a surgical procedure to remove the endothelium of the internal carotid artery along with the proliferating plaque.