Watch Dr. Ulas Cikla, M.D., Dr. Kutluay Uluc, M.D., and Dr. Mustafa K. Baskaya, M.D. from the Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin present a 66-year-old man with seizure, aphasia, and hemiparesis. Work-up revealed a giant partially thrombosed aneurysm of the internal carotid artery bifurcation with surrounding vasogenic edema. He underwent clip reconstruction of the aneurysm via a cranio-orbital approach. Although we prepared for bypass with the radial artery and/or the superficial temporal artery, we were able to clip-reconstruct the aneurysm without bypass. The patient improved upon his pre-morbid state after surgery and made an excellent recovery.