Thomas Meinel, MD, Bern University Hospital, and University of Bern, Bern, Switzerland, discusses covert brain infarctions in patients with manifest stroke and in patients with no stroke symptoms where the additional chronic post-ischemic lesions are incidental findings, for example, when the lesions are found while using MRI on a patient for any other reason besides suspicion of stroke. Dr Meinel debates whether the work-up for those patients should be the same. Because the risk factors are very similar for both groups, the work-up can be considered, but it’s important to consider the phenotype. This interview took place during the European Academy of Neurology 2021 congress.