52 year old church minister developed dizziness and headaches over her left eye. On examination, a bruit, the sound of rushing blood, could be heard behind her left ear. Although an MRI brain scan did not show an abnormality, a cerebral arteriogram demonstrated a dural fistula of the tentorium, the dural lining of the brain that separates the cerebral hemisphere from the cerebellum. The patient was offered open surgery but chose instead endovascular treatment. Using a combination of transarterial and transvenous techniques, the fistula was cured without the need for open surgery. Her headaches and dizziness resolved, and she resumed her ministry nearly immediately following treatment.