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Ankara Numune Hastanesi, 2. Nöroşirürji Kliniği, Ankara, Türkiye Quadrigeminal cistern arachnoid cysts (QACs) are the third most common posterior fossa arachnoid cysts of childhood if middle fossa arachnoid cysts are excluded. These cavities are believed to be congenital and patients usually present with headache, nausea, vomiting, hearing loss, dizziness, behavioral disturbances and psychomotor retardation. QACs are localized between the collicules and cerebellum is usually compressed inferiorly. 14 year old girl was referred with vomiting, diplopia, headache, imbalance and muscle cramps in lower extremities. It was learnt from the clinical history that she had been shunted due to hydrocephalus secondary to QAC. At the operation shunt system was reorganized: A separate pump and shunt catheter was inserted into the QAC which were connected with the pump and shunt from the lateral ventricle with a Y connector to the peritoneal end. Postoperative CT examination showed decrease in dimensions of both cyst and the ventricles together with marked improvement in clinical condition. Stereotactic aspiration, cyst fenestration with endoscopy, cystocisternostomy, cystoventriculostomy, cystoperitoneal shunt and excision with craniotomy are the most commonly used surgical methods. Patients having QAC with aqueduct stenosis should be shunted with separate pumps which supply discrete control of pressures both in cyst and ventricle. Anahtar Kelimeler : Quadrigeminal cistern, Arachnoid cyst, Ventriculoperitoneal shunt, Hydrocephalus, Y connector