Thromboembolic ischemic stroke and the presence of necrotic platelets: a scanning electron microscopy investigation

Stroke is one of the most debilitating diseases worldwide, with its occurrence increasing in Western societies. Central to the pathogenesis of thromboembolic stroke is the involvement of platelets. During thromboembolic events, nucleated cells undergo cell death, and platelets are also affected by parameters causing these incidents. Particularly, initiation of necrotic cell death at sites of vascular injury may play an important role in inducing inflammatory and repair processes. In the current research, the authors investigate whether a changed platelet ultrastructure is visible in thromboembolic stroke and whether it might be visible in platelets as apoptosis or necrosis. Therefore, in the current investigation, the authors study smears of platelet-rich plasma (PRP) from thromboembolic ischemic stroke patients to investigate whether a changed morphology is visible in distressed platelets. Scanning electron microscopy is used and platelets are viewed at up to 200,000× machine magnification. Results indicate that thromboembolic ischemic stroke causes membrane tears and swollen platelets, and this is indicative of necrosis. It is therefore concluded that this morphology might be due to the pro-coagulant activity characteristic of the disease.