BrainNow Research Institute 1 article published in JoVE Behavior Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping J. Matthijs Biesbroek1, Hugo J. Kuijf2, Nick A. Weaver1, Lei Zhao3, Marco Duering4, Meta VCI Map Consortium, Geert Jan Biessels1 1Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, 2Image Sciences Institute, University Medical Center Utrecht, 3BrainNow Research Institute, 4Institute for Stroke and Dementia Research, University Hospital, LMU Munich Provided here is a practical tutorial for an open-access, standardized image processing pipeline for the purpose of lesion-symptom mapping. A step-by-step walkthrough is provided for each processing step, from manual infarct segmentation on CT/MRI to subsequent registration to standard space, along with practical recommendations and illustrations with exemplary cases.