Role of platelets in vasogenic brain edema. I. Significance of thrombus formation in the damaged vessels.

In an investigation of the role of platelets in vasogenic edema in cats, direct observation of the cortex revealed that within several minutes after cold injury, platelet thrombi formed in small veins at the point where the veins emerged from the depths of the brain. Later, edema fluid extravasated from the veins at this same point. Pretreatment with a platelet inhibitor, RA-233, abolished the formation of platelet thrombi and remarkably enhanced the leakage of edema fluid. The microcirculation was assessed by carbon black perfusion and was found to fill better in the cats that received the platelet inhibitor. The better filling may be ascribed to a decreased number of thrombi and consequent improved blood flow in small blood vessels. We conclude that platelet aggregates play a major role in controlling the leakage of edema fluid after cold injury.