Homovanillic acid and 5-hydroxyindoleacetic acid in the ventricular CSF of comatose patients with obstructive hydrocephalus

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Abstract
Ventricular CSF levels of homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) were determined every 2-4 h over a period of 1-4 days in 12 patients; consisting of 7 cases of brain tumor, 2 cases of cerebrovascular disease and 3 cases of head injury. The concentrations of HVA and 5-HIAA varied with time in all cases and significant correlations were found between the 2 values in 8 cases. The relationship between variations of HVA and 5-HIAA levels and rhythms of sleep and waking could not be clarified. Both HVA and 5-HIAA concentrations varied at high levels in 2 patients whose CSF flow was completely blocked by tumor at the site of the 4th ventricle and aqueduct, respectively. In a case with craniopharyngioma in the 3rd ventricle, which blocked the bilateral foramina of Monro, although the HVA values were high, the 5-HIAA values varied at low levels. Of 5 comatose patients, 2 had cerebrovascular lesions and 3 had sustained head injury, and, in 4 of the 5, the values of either one or both of HVA and 5-HIAA were low, but in the 5th case the 5-HIAA value was high. Estimation of HVA and 5-HIAA concentrations in ventricular CSF may be a valuable tool in the investigation of brain monoamine metabolism. Many factors must be considered in the interpretation of results of clinical studies.
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