https://www.selleckchem.com/products/mki-1.html 8 minutes). The MITF technique exposed the longest IMAX segment (mean, 18.8 ± 3.5 mm). Advantages of the AMITF and MITF techniques include anatomic simplicity, absence of skull base drilling, and greater discretion in muscle dissection. These properties can simplify the anastomosis procedure compared with the ALMF and LMF techniques. Identification of the IMAX pattern is important before selecting the approach for this bypass operation. Advantages of the AMITF and MITF techniques include anatomic simplicity, absence of skull base drilling, and greater discretion in muscle dissection. These properties can simplify the anastomosis procedure compared with the ALMF and LMF techniques. Identification of the IMAX pattern is important before selecting the approach for this bypass operation.Absence of the internal carotid artery (ICA) is a rare congenital anomaly. Six pathways of alternative collateral circulation have been described. We present a case depicting absence of the left ICA and a Lie type D pattern of collateral circulation, with an intercavernous branch from the right cavernous ICA passing along the floor of the sella to the contralateral side, supplying the left middle cerebral artery. Association with cerebral aneurysms has been found, as seen in this case. Recognition of this vascular anatomic variant is important to understand thromboembolic disease in these patients and the increased risks of surgery, such as transsphenoidal pituitary surgery. Also, it highlights the importance of imaging these patients to detect and monitor associated cerebral aneurysms. The coronavirus disease 2019 (COVID-19) pandemic has infected more than 13 million people on a global scale and claimed more than half million deaths across 213 countries and territories. While the focus is currently on recovery from the pandemic, the disease has significantly changed the way we practice medicine and neurosurgery in New York City and the Uni