natriuretic peptide (BNP) was 548.4 pg/ml and gradually increased to 979.47 pg/ml. Comprehensive data suggest that the patient has cardiac insufficiency. Control of the ventricle rate to prevent stroke. Strictly control the 24-hour access volume to avoid water and sodium retention. Give medicines to strengthen the heart, diuresis, and improve heart function.On the 11th postoperative day, the patient had a sudden decrease in consciousness and a decrease in the muscle strength of the right limb (Grade II). Computed tomography showed low-density shadows in the left cerebral hemisphere and no obvious bleeding (Fig. 2B). Computed tomography angiography showed severe stenosis and occlusion in the M2 segment of the left middle cerebral artery, and the distal branches were significantly sparser than the opposite side (Fig. 2C). Computed tomography perfusion imaging (CTP) indicates partial core infarction of the left frontotemporal parietal lobe (Fig. 2D). The patient has a history of atrial fibrillation. Acute stroke is considered for this acute attack, but CV cannot be ruled out. For differential diagnosis and treatment without delay, cerebrovascular angiography is preferred. Intraoperative angiography showed that the left posterior traffic, the middle cerebral artery slender, the blood flow was slow, and the flow rate decreased significantly. Fasudil was injected intrathecally during the operation (Fig. 2E-H). Twelve days after the occurrence of CV, CT showed edema in the left cerebral hemisphere, the midline was in the middle, and the left lateral ventricle was slightly compressed (Fig. 2I). After acute left heart failure, the patient developed multifunctional failure, abnormal coagulation function, renal insufficiency, lung infection, shock, and finally respiratory and cardiac arrest.