[The intrathecal manometric lumbar infusion test (Katzman Test) in the diagnosis of normotensive hydrocephalus].

Over 12-months 17 patients were admitted to the hospital for the presumed diagnosis of normal pressure hydrocephalus (NPH). Four patients had cardinal signs of the syndrome: gait disturbance, dementia and urinary incontinence. Six patients had gait disturbance and dementia. Five patients had gait disturbance and ventricular enlargement on CT scans of the brain, while the last two patients had only urinary incontinence and dementia. All patients underwent neurological examination and CT scans. Clinical and radiological results of these patients were compared with the results of the Katzman's test. Katzman's test was performed in all patients. Physiologic solution of 0.9% NaCl was infused in the lumbal subarachnoid space. The rate of infusion was 1 ml/min during 60 minutes. Cerebrospinal fluid (CSF) pressure was recorded simultaneously using metal aneroid. The test was considered positive if either CSF pressure over 300 mm H2 or undulating waves were recorded at any time of the test. Katzman's test was positive in 12 patients (9 of them with NPH). The undulating waves were recorded in 6 patients (5 with NPH). Four of them experienced tachycardia, hyperventilation, cephalea and mild confusion during the test. The test was positive in all 9 patients with NPH but also in 3 patients with different but pathophysiologically similar disorders. The test was positive in all 4 patients with the characteristic clinical triad of the syndrome and also in all 4 patients with periventricular hypodensity on their CT scans. No patient without gait disturbance had positive test. All except one patient with focal signs or pronounced cortical atrophy, besides with dramatic clinical improvement.(ABSTRACT TRUNCATED AT 250 WORDS)