Comparative evaluation of 5-HIAA (5-hydroxy indoleacetic acid) and HVA (homovanillic acid) in infantile hydrocephalus

Abstract

Infantile hydrocephalus is a common congenital problem. Functional and behavioral disturbances associated with hydrocephalus may be due to altered neurotransmitters in the brain. The role of neurotransmitters has been established in various psychiatric and neurological conditions. Therefore, we decided to study the role of 5-hydroxy indoleacetic acid (5-HIAA) and homovanillic acid (HVA) in cerebrospinal fluid (CSF) of hydrocephalic patients as diagnostic and prognostic marker. Ventricular CSF samples were taken from hydrocephalic patients peroperatively and at days 7 & 30. Control CSF samples were taken from nonhydrocephalic patients operated for other conditions. Samples were analyzed for 5-HIAA and HVA, and results were obtained accordingly. Values of 5-HIAA and HVA showed a highly significant decrease after shunt insertion. No significant difference in values of 5-HIAA and HVA were observed in relation to age and duration of disease. The CSF ventriculo-lumbar gradient for both 5-HIAA and HVA done in six patients was statistically significant only in the noncommunicating group. Both the neurotransmitter metabolites 5-HIAA and HVA are found to be significantly high in the hydrocephalus, but 5-HIAA is a more sensitive parameter. These markers levels decrease after shunt insertion. Thus, estimation of these metabolites could be valuable markers for its diagnosis and follow-up.