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摘要

We greatly appreciate the comments. We do agree that after a large ischemic stroke, the cerebral autoregulation can be severely compromised, and any procedures or treatments that could potentially decrease cerebral blood flow should be avoided at all cost. In this specific case, the patient presented with multiple embolic episodes to different organs (not fully described due to text length restrictions of a case report), and surgery was deemed a life-saving measure. There are scant and discouraging data about anticoagulation in this situation. Moreover, there is some evidence that cardiac myxomas can result in embolic phenomena in almost half of the patients, even more after the first episode .