Conventional MRI scans may be used to observe neuroimaging markers of cerebral small vessel disease (SVD), including white matter hyperintensities (WMH), lacunes and microbleeds. Anil Man Tuladhar, MD, PhD, Radboud University Medical Center, Nijmegen, Netherlands, explains that a single lesion is not enough to result in cognitive impairment leading to dementia, but rather this may be caused by the cumulative effect of multiple different lesions. For instance, damage to white matter regions or atrophy can impact the connections crucial for proper brain functioning, potentially leading to cognitive impairment and dementia. Additionally, damage can occur that cannot be visualized using conventional imaging, meaning the true extent of damage may not be realized. This interview took place at the European Stroke Organisation Conference (ESOC), 2021.