Plasma monoaminergic metabolites and catecholamines in subarachnoid hemorrhage. Clinical implications

We examined plasma catecholamines and monoaminergic metabolites (3-methoxy-4-hydroxyphenylethyleneglycol [MHPG], homovanillic acid [HVA], and 5-hydroxyindoleacetic acid) in patients with stroke successively up to three weeks after the initiation of symptoms. Plasma levels of free catecholamines were significantly elevated in patients with subarachnoid hemorrhage (SAH). However, no significant differences in plasma catecholamines were found when the patients with SAH were subdivided into noncomatose and comatose groups. In contrast, plasma HVA, MHPG, and 5-hydroxyindoleacetic acid levels in comatose patients with SAH significantly increased as compared not only with normal controls but also with noncomatose patients with SAH, and the peak levels of HVA and MHPG occurred within seven days poststroke. Such trends as observed in SAH were not observed in patients with cerebral hemorrhage. Our results suggest the usefulness of plasma monitoring of possibly centrally originating monoaminergic metabolites for predicting the degree of cerebral dysfunction in patients with SAH.