What causes cerebral palsy? Risks, brain damage & prevention
Understanding what causes cerebral palsy can help parents make sense of a difficult diagnosis. CP typically results from brain damage before, during, or shortly after birth, from oxygen deprivation and infections to avoidable medical mistakes during delivery.
Children in the U.S. are affected by cerebral palsy
~50%
Of those with CP experience speech or language disorders
70–80%
Of CP cases are the spastic type, caused by motor cortex damage
What causes cerebral palsy in babies?
Cerebral palsy is a lifelong condition stemming from brain damage or abnormal brain development, typically occurring before, during, or shortly after birth. About 85–90% of cases are congenital, meaning the brain injury happened prenatally or around the time of birth.
Congenital CP can result from prenatal disruptions such as infections, placental insufficiency, or genetic differences that interfere with brain development, or from perinatal complications such as oxygen deprivation during labor, strokes, or birth trauma, especially in premature or low-birth-weight infants.
The remaining 10–15% of cases are acquired after birth, caused by events like brain infections (meningitis or encephalitis), head injuries, severe jaundice, or stroke in infancy.
Unfortunately, a significant number of infant brain injuries leading to cerebral palsy are still caused by avoidable medical mistakes during delivery. If you suspect your child’s condition was preventable, a qualified birth injury lawyer can review your case at no cost.
Brain injury causing cerebral palsy can be pinpointed to one of three periods. Understanding the timing helps doctors identify the cause and guides decisions about treatment and, when relevant, legal action.
Prenatal: Before birth
Often linked to brain malformations, infections, or disturbances in fetal blood flow. This accounts for the majority of congenital CP cases.
Perinatal: During labor & delivery
Oxygen deprivation, strokes, brain hemorrhage, or delivery-related injuries during or immediately around the time of birth. The most time-sensitive window for preventing injury.
Postnatal: After birth (up to age 2)
Meningitis, traumatic injury, severe jaundice (kernicterus), or stroke in infancy. Accounts for 10–15% of all CP cases.
Neuroimaging such as MRI can show brain injury patterns that cause cerebral palsy in more than 80% of cases, helping identify the pattern of injury and when it occurred. Still, many cases lack a clear timestamp. In these situations, a qualified nurse or lawyer reviewing a child’s birth records can help determine whether mistakes were made.
CP fact
Even cerebral palsy that is present at birth may not be detected for up to 2 years. If you have concerns about your child’s development, contact us today for a free evaluation.
Prenatal causes of cerebral palsy
During pregnancy, a baby’s brain is extremely susceptible to disruption. Most prenatal risks are manageable with quality care, but when they go undetected or untreated they can result in permanent brain injury. For a deeper look, see our guide on prenatal causes of cerebral palsy.
The most common prenatal risks for brain damage are well characterized.
Prenatal causes account for the majority of cerebral palsy. Maternal infections including rubella, cytomegalovirus and Zika trigger inflammation that disrupts neurodevelopment, and a meta-analysis put clinical chorioamnionitis at a relative risk of 1.9 for cerebral palsy in preterm infants and 4.7 at term. Poor placental function and growth restriction chronically under-oxygenate the developing brain. Genetic variants account for far more than was once assumed: exome sequencing found a causative variant in 32.7% of a clinical laboratory referral cohort of 1,345 patients and 10.5% of a health-system cohort of 181, with pathogenic variants spread across 229 different genes. Structural brain abnormalities originate in the first and second trimesters. Prenatal stroke follows a blocked or ruptured vessel, often linked to maternal clotting disorders or preeclampsia. And toxin exposure, whether alcohol, certain medications or environmental agents, interferes with development during specific vulnerable windows.
Early prenatal care, infection screening, nutritional guidance, and access to maternal-fetal medicine can significantly reduce these risks. If prenatal complications were missed or mismanaged, the resulting brain injury may be grounds for a medical malpractice claim.
What can go wrong during labor & delivery?
The perinatal period (just before, during, and immediately after birth) is one of the most delicate phases of a baby’s life. During this short window, even minor delays in medical decision-making can have life-altering consequences. See our guide on birth complications that cause cerebral palsy for a deeper look.
A baby’s brain is highly vulnerable to any disruption in oxygen supply, blood flow, or mechanical trauma during delivery. While not all perinatal complications are preventable, many are, which is why medical expertise and timely treatment matter most during this critical time.
Birth asphyxia and hypoxic-ischemic encephalopathy (HIE)
This occurs when a baby’s brain doesn’t receive enough oxygen and/or blood flow before or during delivery. Causes include prolonged labor, placental abruption, uterine rupture, or a compressed umbilical cord. If not addressed quickly, HIE can result in severe brain injury and is a leading cause of spastic quadriplegic CP. Some babies may qualify for therapeutic hypothermia (cooling treatment) if identified within six hours of birth. See our deeper guide on birth oxygen deprivation and HIE.
Umbilical cord accidents
The umbilical cord is the baby’s lifeline. Problems like cord prolapse (where the cord slips through the cervix before the baby) or nuchal cords (cord wrapped around the neck) can quickly cut off oxygen. True knots in the cord, though rare, can tighten during contractions and block blood flow.
Traumatic deliveries
Difficult vaginal births can cause direct injury.
Delivery complications contribute in a minority of cases. Shoulder dystocia traps the baby’s shoulder, producing excessive traction, nerve damage and delay. Forceps or vacuum extractor misuse can cause skull fracture, intracranial bleeding or swelling. And excessive traction can damage the cervical spine and nerves on top of whatever else is happening.
Prematurity and low birth weight
Babies born before 32 weeks or under 3.3 pounds face a significantly higher risk of intraventricular hemorrhage (IVH), which is bleeding in the brain’s fluid-filled spaces, and periventricular leukomalacia (PVL), white-matter brain injury strongly associated with spastic diplegia. Premature infants also face respiratory challenges that can lead to periods of low oxygen saturation, compounding risk. See our guide on premature birth and cerebral palsy for a deeper look.
Neonatal stroke or hemorrhage
Some infants experience a stroke (a blockage or rupture of blood vessels in the brain) before or during delivery. Risk factors include maternal clotting disorders, preeclampsia, or prolonged labor. Strokes may go unnoticed for weeks until the baby shows signs like hand preference or asymmetrical movement.
Find out if medical mistakes caused your child’s CP
Poor fetal monitoring, delayed C-sections, or failure to act on signs of distress can contribute to a baby’s injury. Have your case reviewed by a lawyer today, at no cost.
Medical negligence and preventable causes of cerebral palsy
One of the most difficult truths for a parent is when cerebral palsy results from medical errors that could have been avoided. When doctors or hospital staff fail to uphold accepted standards of care during labor and delivery, the consequences can be devastating and permanent.
Common medical mistakes linked to CP
The failures that recur in birth injury claims are specific: overlooking fetal distress on the monitoring trace, misusing forceps or a vacuum extractor, mishandling a prolapsed or compressed cord, delaying a medically necessary cesarean, and failing to diagnose or treat an infection. It is worth being clear that most cerebral palsy is not caused this way. In the classic analysis of 189 affected children, only 9% had markers suggestive of asphyxia without another intrinsic defect that could explain the outcome, and adding birth and neonatal events to pre-labor risk factors raised the share of cases explained from 34% to 37%.
Too often, families are left in the dark. Medical records may be vague, explanations evasive, and straight answers hard to come by.
Healthcare professionals are trained to make quick, informed decisions under pressure. But when protocols aren’t followed or red flags are missed and a child is harmed as a result, accountability matters. Hospitals and their insurers have a duty to cover the costs of care when their negligence causes injury.
If you suspect that a preventable error contributed to your child’s cerebral palsy, consult an experienced birth injury lawyer. They can review the medical records, investigate the timeline, and help determine whether your child’s condition was avoidable, and whether your family is entitled to compensation.
Cerebral palsy causes by brain damage area
The type of cerebral palsy a child develops depends largely on where in the brain the damage occurred. Rather than a singular diagnosis, CP is a spectrum of movement disorders shaped by which neural circuits were injured and how early the injury happened.
Understanding these distinctions helps doctors guide custom-tailored therapies to maximize a child’s capabilities: whether that’s tone management, mobility aids, or speech support. Learn more about the types of cerebral palsy and how each is treated.
70–80%
Spastic CP, motor cortex damage
~10%
Dyskinetic, basal ganglia damage
5–10%
Ataxic, cerebellum damage
Most common · 70–80%
Spastic cerebral palsy
Caused by damage to the motor cortex or pyramidal tracts. Characterized by muscle stiffness and tight, jerky movements.
Where the injury sits determines the type. White matter injury near the ventricles produces spastic diplegia, affecting the legs more than the arms. Grey matter injury produces spastic hemiplegia on one side or quadriplegia across all four limbs. And spastic quadriplegia is the pattern most often associated with severe oxygen deprivation.
Dyskinetic / athetoid
Dyskinetic cerebral palsy
Results from injury to the basal ganglia or thalamus, regions that control involuntary movement.
Dyskinetic cerebral palsy presents as fluctuating tone, moving between limp and stiff, with uncontrolled writhing or twisting movements and difficulty controlling the facial muscles, which affects both speech and eating. It follows damage to the basal ganglia, most often after severe birth asphyxia or untreated jaundice.
Rarest type · 5–10%
Ataxic cerebral palsy
Tied to damage in the cerebellum, the brain’s balance and coordination center. Diagnosis is sometimes delayed due to subtle early signs.
Ataxic cerebral palsy, the rarest form, shows as shaky movement and poor balance, an unsteady gait with depth perception problems, and difficulty with fine motor tasks such as writing or fastening buttons. It follows cerebellar involvement.
Multiple brain areas
Mixed cerebral palsy
Occurs when multiple areas of the brain are affected, producing a blend of symptoms.
Mixed cerebral palsy follows damage across several regions, and the usual precipitants are severe birth trauma, prolonged oxygen deprivation, or diffuse injury and infection. Spasticity combined with involuntary movement is the commonest combination.
How do doctors determine the cause of cerebral palsy?
Identifying the cause of cerebral palsy is a complex process that blends clinical investigation with advanced diagnostic tools. Because CP can result from prenatal, perinatal, or postnatal factors, doctors work through all three periods to find the origin.
Medical and birth history review
The first step is a deep dive into the child’s prenatal and delivery history. Doctors examine risk factors such as premature birth, low birth weight, maternal infections during pregnancy, and signs of fetal distress during labor. Problems during delivery (like oxygen deprivation or delayed C-section) are also scrutinized for possible connections to brain injury.
Neuroimaging and brain scans
MRIs play a central role, offering detailed views of the brain’s structure. In over 80% of CP cases, MRIs reveal patterns that suggest when and how the injury occurred: whether due to stroke, brain malformation, bleeding, or lack of oxygen. These insights help distinguish CP from other neurological conditions and often provide a timeline for when the damage took place. Learn more about the full cerebral palsy diagnosis process.
Genetic and metabolic testing
When MRI results are inconclusive or show unusual brain development, genetic testing may be recommended. Emerging research shows that genetic or metabolic disorders may mimic or contribute to cerebral palsy symptoms. Testing can rule out progressive or hereditary conditions, offering clarity and informing family planning.
Neurological and developmental assessments
Pediatric neurologists assess a child’s motor function, reflexes, muscle tone, coordination, and cognitive or language development. These evaluations not only confirm a cerebral palsy diagnosis but also guide early intervention strategies tailored to the child’s specific needs.
When a cause isn’t found
Despite thorough investigation, a definitive cause of cerebral palsy isn’t always identified. In many cases it’s a combination of subtle factors rather than a single event. Ruling out progressive diseases and confirming that the condition is not worsening matters regardless. In situations where doctors aren’t able to identify the cause, a qualified nurse or lawyer reviewing your child’s birth records may uncover mistakes that contributed to the injury.
Cerebral palsy is not always preventable, but a significant number of cases may be avoided or reduced through thorough, proactive medical care at every stage, from early pregnancy through the neonatal period.
Prenatal care and risk reduction
High-quality prenatal care is among the most effective tools for reducing risk.
Prevention before birth is a short list with real effect: screening and treating maternal infections, managing preeclampsia and gestational diabetes, adequate folic acid and healthy maternal weight, and keeping to the schedule of ultrasounds, lab work and vaccinations. Hand hygiene around toddlers belongs here too, since cytomegalovirus is the most common congenital infection in the country and usually comes from a small child’s saliva.
High-risk pregnancy management
When complications arise, such as intrauterine growth restriction (IUGR), placental insufficiency, or multiple gestation, specialized monitoring becomes critical. Timely referrals to maternal-fetal medicine specialists, along with advanced imaging and fetal heart monitoring, can guide decisions that protect the baby from injury.
Labor and delivery protocols
The intrapartum period is a high-risk window for CP-related injuries, particularly those caused by asphyxia or trauma.
During delivery, prevention means continuous electronic fetal monitoring, prompt interpretation of abnormal heart rate patterns, and timely action when they appear, whether repositioning, medication or an emergency cesarean. Correct use of forceps and vacuum extractors completes the list. Four monitoring patterns carry most of the weight: late decelerations signal placental insufficiency, variable decelerations signal cord compression, loss of variability signals a compromised baby, and sustained tachycardia or bradycardia signals both.
Immediate newborn care
Even after a safe delivery, the neonatal period presents risks. Newborns must be promptly assessed for jaundice, infections, and signs of hypoxic-ischemic encephalopathy (HIE). Therapeutic hypothermia (cooling the infant’s body temperature) can reduce the extent of brain injury if started within six hours of birth. Early detection and treatment of complications in the NICU can make a measurable difference.
Legal options when medical error is suspected
An unfortunate number of cerebral palsy cases are caused by birth injuries from medical errors that could have been prevented. When healthcare professionals fail to provide the standard of care expected during labor and delivery, the consequences can be devastating.
When medical mistakes appear to have contributed to cerebral palsy, the injured child and their family have the right to recover substantial damages through legal action. Every state has laws allowing recovery of damages when a person is injured as a result of medical malpractice.
Factors to consider when deciding whether to pursue a claim
1Was the care provided during delivery abnormal or below the normal standard of practice?
2Did my child suffer a permanent injury as a result?
3Can I obtain medical evidence like birth records to demonstrate substandard care?
4How long do I have to file a claim before my rights expire? (See: statute of limitations)
5How would a substantial award help my child’s treatment and lifelong care?
Verdicts and settlements for lifetime care needs of those with cerebral palsy or brain damage often reach well into the millions of dollars. These awards can fund your child’s treatment and wellbeing, as well as your family’s ability to manage daily life.
If your child suffered a birth injury like cerebral palsy and you suspect something went wrong before or during your delivery, a qualified lawyer should examine your case. A lawyer can identify substandard care, collect evidence, determine how long you have to file, and pursue an award for all of your damages.
Your family may qualify for compensation
The Cerebral Palsy Center has qualified lawyers who can discuss your case today at no cost. Contact us today to speak directly with a lawyer.
Frequently asked questions about cerebral palsy causes
Some of the most common risk factors and causes of cerebral palsy include injury from delivery, oxygen deprivation during delivery, premature birth, untreated jaundice, delayed delivery, infections during pregnancy, and prenatal exposure to excessive toxins. While many causes occur naturally, a large number are due to avoidable medical mistakes.
Yes. Perinatal stroke can occur in around 1 out of 3,000 births either just before, during or right after delivery. This can cause hemiparetic cerebral palsy, which leads to paralysis of one side of the body.
While an MRI cannot provide a definitive diagnosis of cerebral palsy, it is a useful tool for identifying brain damage that can lead to further testing to conclusively diagnose CP. MRIs reveal injury patterns in more than 80% of CP cases. Other tools used alongside MRIs include the Prechtl Qualitative Assessment of General Movements (GMs) and the Hammersmith Infant Neurologic Examination (HINE).
Birth injuries occur near or during the time of delivery, while birth defects usually happen much earlier during the first few months of pregnancy. Cerebral palsy is classified as a birth injury since it is often caused by brain damage just before, during or soon after the delivery process. Other types of brain damage that occur during the baby’s development in pregnancy are classified as birth defects.
Most cases of cerebral palsy are not genetic, but rather linked to premature birth or oxygen deprivation during delivery. However, recent studies have found that genetic factors may play a part in up to 25% of cerebral palsy cases in which no other risk factor can be identified.
The majority of cerebral palsy cases are caused by brain damage suffered around the time of birth. However, new studies suggest that genetic factors (which are inherited) may have a role in around 20–25% of brain injury cases in which no other risk factor can be identified.
