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.
Medically reviewed
Updated April 2026
~ min read
1 in 340
Children in the U.S. are affected by cerebral palsy
75%+
Of those with CP experience speech or language disorders
75–85%
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 and cerebral palsy include:
Maternal infections (rubella, CMV, Zika) — can spark inflammation that disrupts neurodevelopment
Poor placental function or fetal growth restriction (IUGR), leading to chronic under-oxygenation of the developing brain
Genetic mutations — research shows up to 11% of cerebral palsy may involve monogenic or developmental brain disorders
Structural brain abnormalities — detectable with advanced imaging, originating in the first and second trimesters
Prenatal stroke — blood vessel blockage or rupture in the fetal brain, linked to maternal clotting disorders or preeclampsia
Exposure to toxins — certain medications, alcohol, or environmental toxins during pregnancy can interfere with brain development
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 result in direct injury. Common causes include:
Shoulder dystocia — the baby’s shoulder gets stuck, leading to excessive pulling, nerve damage, and delayed delivery increasing brain trauma risk
Forceps or vacuum extractor misuse — can cause skull fractures, intracranial bleeding, or brain swelling (cephalohematoma)
Excessive traction — can damage the cervical spine and nerves, compounding injury
Prematurity and low birth weight
Babies born before 32 weeks or under 3.3 pounds face a significantly higher risk of intraventricular hemorrhage (IVH) — 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
Overlooking signs of fetal distress, such as abnormal heart rate patterns during labor
Improper use of forceps or vacuum extractors, causing physical trauma or oxygen deprivation
Mishandling a prolapsed or compressed umbilical cord
Delaying a medically necessary cesarean section (C-section)
Failing to diagnose or treat infections that trigger inflammation and damage a developing brain
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.
White matter injury (PVL) → spastic diplegia (legs primarily)
Gray matter injury → spastic hemiplegia (one side) or quadriplegia (all four limbs)
Spastic quadriplegia often linked to severe oxygen deprivation
Dyskinetic / athetoid
Dyskinetic cerebral palsy
Results from injury to the basal ganglia or thalamus, regions that control involuntary movement.
Fluctuating tone (limp to stiff)
Uncontrolled writhing or twisting movements
Difficulty controlling facial muscles, affecting speech and eating
Often linked to birth asphyxia or kernicterus
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.
Shaky movements and poor balance
Unsteady gait and depth perception issues
Fine motor challenges like writing or buttoning
Multiple brain areas
Mixed cerebral palsy
Occurs when multiple areas of the brain are affected, producing a blend of symptoms. Often associated with:
Severe birth trauma
Prolonged oxygen deprivation
Diffuse brain injury or infections
Spasticity combined with involuntary movements
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 take a comprehensive approach to uncover its origins.
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 a non-worsening condition is crucial 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 minimized through comprehensive, proactive medical care at every stage — from early pregnancy through the neonatal period.
Prenatal care and risk reduction
High-quality prenatal care is one of the most effective tools in reducing CP risk. This includes:
Screening and treating maternal infections
Managing conditions like preeclampsia and gestational diabetes
Ensuring adequate folic acid intake and maintaining healthy maternal weight
Routine ultrasounds, lab work, and vaccinations throughout pregnancy
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. Best practices include:
Continuous electronic fetal monitoring to detect signs of distress
Swift interpretation of abnormal fetal heart rate patterns
Timely intervention — repositioning, medication, or emergency C-section
Proper use of delivery instruments such as forceps or vacuum extractors
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 provide vital help for 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, it’s crucial to have a qualified lawyer 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.
