The cases of two patients with hypertensive hydrocephalus and Parinaud syndrome are reported. In both cases the ventriculographic studies showed a cystic expansion of the suprapineal recess. The upward gaze palsy was related with the expansion of the suprapineal recess. The radiological study of the posterior portion of the third ventricle in these cases is recomended. The use of inadequate devices in these situations may cause the worsing of the patient.