Good evening. My name is Dr. Dariush Saghafi and I am a neurologist in Cleveland, Ohio, USA. I agree that surgery on a 78 year old gentleman with what sounds to be cortical atrophy resulting in enlarged ventricles and what could be interpreted as excess fluid or hydrocephalus is not a good idea at all. Even if the surgeon wants to say that he had a condition known as Normal Pressure Hydrocephalus so that he can have a shunt placed the liklihood that the shunt will actually make him measurably better is poor. I hate to put it this way but in my opinion and judgement if the surgeon is telling you that surgery is absolutely necessary under these conditions and if your father as severe or even moderately severe Alzheimer s disease then, the surgeon is either very very out of touch with what the literature says about such conditions and the fact that a shunt represents a HIGH risk of morbidity and mortality with little chance of success.....OR the surgeon is trying to convince you of something that he knows is not true and that would be the equivalent of taking advantage of your father and the family just to charge for a procedure. If you feel that it is not a good idea...and from the description of what s going on I agree with you then, you must PUT YOUR FOOT DOWN and say no.....take him out of the hospital and take care of your father at home for now until you can find a reputable neurologist where he lives who will guide you to good decisions for his condition....not try and take advantage of a desperate situation to either make money for himself....or just be making bad recommendations simply because he is ignorant of the most recent information on the subject. If you are interested in maintaining communication with me or if you have some films or reports of films (which are in English....unfortunately, the only other language I can read fluently is SPANISH.....though I speak and understand some Farsi...I cannot read or write it) then, you may write a PREMIUM QUESTION on this website and address it specifically to me (DARIUSH SAGHAFI, MD) and I will be watching for it and answer you. You may also find me on live webcam over the internet giving telemedicine consults at www.healthtap.com/drsaghafi on Wed-Sat. from 3a-6a (New York City Time Zone) and also on the same network on Sun. 11p-3a. If you would like to conference live by webcam camera and show me your father at the same time I can tell you whether I think he is a good candidate for any surgery. My guess at this moment is clearly NOT a candidate. Do not allow surgery until you get more information either from myself or from a reputable and trustworthy neurologist. Don t go to neurosurgeons for anything at this time because they may be misleading you. Good luck. If you find this answer useful please give a STAR RATING and a brief commentary. Thank you.