Homovanillic acid and 5-hydroxyindoleacetic acid modifications in CSF of patients with stroke and multi-infarct dementia.

Thirty four patients who had complete ischemic stroke confirmed by neurologic examination, were divided into three groups according to the time elapsed between the first signs of stroke and lumbar puncture: group A, 22-47 h; group B, 48-71 h; group C, 72-96 h. Nineteen patients with multi-infarct dementia (MID) assessed by neurologic and neurophysiologic examinations were also studied. The severity of the neurological deficit was assessed by the Norris rating scale. Nine age-matched subjects without neurologic disease served as controls. Levels of homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) were determined in lumbar CSF by a fluorimetric method after separation on Sephadex G-10 columns. HVA levels decreased as the length of time after stroke increased and were lower than controls in MID, while 5-HIAA levels were low in group B and MID. Our results in stroke can be interpreted as showing they are the consequence of dopamine and serotonin global depletion in the early phases of brain ischemia. In MID, the CSF changes might reflect not only tissue loss secondary to multiple infarcts but also the persistence of a state of diffuse ischemia.