What is the way to solve NPH problem in an 85 years old?

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I have read your concern, and I have seen the imaging studies (attachment removed to protect patient identity). If before the problem your father is 85 years old active, can walk, can change clothes by himself, can eat by himself, then a VP (Ventriculoperitoneal) shunt insertion would help. The imaging shows hydrocephalus, and some of the symptoms of NPH (Normal Pressure Hydrocephalus) may come from this. However, there is an obstructing tumor in the posterior fossa. As I see, this may be a metastasis of an epidermoid tumor. I would suggest further investigation with your neurosurgeon on this matter. For the question of a VP shunt (ventriculoperitoneal shunt), the answer is yes, and this could help your father even if he is 85 years old. You need to have medical clearance from your cardiologist and pulmonologist to undergo the operation.

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A lumbar puncture would also help to rule out NPH (Normal Pressure Hydrocephalus) at this point, and you would have to take into consideration first the obstructing tumor that blocks the fluid circulation in your father's brain. As I see, your father does not have an NPH, but obstructive hydrocephalus proceeding with a shunt rather than a lumbar puncture is warranted.