We have tested the hypothesis that blood-borne substances released from a site of vascular thrombosis can lead to acute alterations in the blood-brain barrier. The right common carotid artery of rats was photothrombosed using a dye/light insult. Rats were given the photosensitizing dye rose bengal and irradiated for 4 minutes with an argon laser beam focused onto the . exposed common carotid artery. During the irradiation, 3 ml of blood was taken from the right external carotid artery. After 10 minutes, the blood was infused into the external carotid artery of a recipient rat that had received horseradish peroxidase. Fifteen minutes after blood infusion, bilateral peroxidase extravasation was noted within cortical and subcortical areas of recipient rats, being most intense ipsilaterally. Ultrastructural studies demonstrated peroxidase reaction product within numerous endothelial vesicles of arteriolar segments. Infusion of blood from control rats did not produce similar changes. Thus, photoinduced vascular thrombosis of a large feeding artery leads to the formation of blood-borne factors that acutely alter cerebral vascular permeability. (Stroke 1988;19:857-862) A bnormalities of blood rheology are believed to Z A play an important role in the pathophysi-A. \~ ology of stroke. Altered platelet function, increased hematocrit, and decreased erythrocyte deformability are just a few of the changes that have been detected in patients with neurologic deficits secondary to cerebral ischemia. '-6 Blood constituents have also been implicated in postischemic reperfusion abnormalities.
-10 In one experimental investigation, the preischemic modification of an animal's blood by exposure to glass wool greatly enhanced postischemic cerebral reperfusion.7 Studies such as these demonstrate that cerebral ischemia can produce blood alterations that in some cases may be detrimental to postischemic brain recovery. However, whether blood abnormalities also represent a primary event in the occurrence of acute stroke still remains unclear. For example, it is not known whether vascular injury in the absence of cerebral ischemia also leads to the Received November 17, 1987; accepted February 26, 1988. formation of blood-borne factors that acutely affect brain structure and function. Experimentally induced thrombosis of neocortical vessels can be produced in rats by means of a rose bengal dye-sensitized photochemical reaction facilitated by irradiation with a filtered xenon arc lamp. "-13 This insult leads to acute alterations in the blood-brain barrier (BBB) and to vasogenic edema within the cortical region destined to undergo ischemic infarction.12 Recently, vascular endothelial damage leading to thrombosis of the middle cerebral artery (MCA) and common carotid artery (CCA) has been accomplished using the focused beam of an argon laser as the light source.14 Photothrombosis of the MCA also resulted in rapid alterations in cerebral vascular permeability, with bilateral leakage of horseradish peroxidase (HRP) 15 minutes after thrombu...