The plasma level of 11-dehydrothromboxane B2 (11-dehydroTXB2) is free from artifactual increase during blood sampling, and it can be reliable indicator of TXA2 production in vivo. We have estimated plasma 11-dehydroTXB2 in patients with ischemic stroke. Subjects studied were 29 patients with cerebral thrombosis (62 +/- 9 years old) and 41 healthy controls (61 +/- 7 years old). Plasma 11-dehydroTXB2 and TXB2 were determined by radioimmunoassay. Plasma 11-dehydroTXB2 levels in patients and controls were 5.4 +/- 2.5 and 1.8 +/- 0.9 pg ml, respectively, and the difference was significant (p less than 0.001). Plasma TXB2 also was higher in patients than in controls: 401 +/- 61 vs 311 +/- 51 pg/ml (p less than 0.05). However, the 11-dehydroTXB2 was found to be a more effective parameter to distinguish between stroke patients and controls. Estimation of plasma 11-dehydroTXB2 levels is a reliable method to detect platelet hyperfunction in stroke patients.