Fetuses and infants can sustain traumatic brain injuries before, during, and after birth, and sometimes these injuries result in cerebral palsy. The Brain Injury Association of America defines a traumatic brain injury as "an alteration in brain function, or other evidence of brain pathology, caused by an external force." In other words, an object comes into contact with the child's skull and causes injury to the brain.
How Brain Damage Occurs
Several external forces can cause traumatic brain injuries in infants. These injuries can result not only in cerebral palsy, but also other conditions and disorders that can impact the baby's development. While some of these are evident right away, cerebral palsy can take up to three or four years to diagnose accurately.
Brain Damage That Causes Cerebral Palsy
In addition to external blows that might cause traumatic brain injury, problems that occur before, during and after delivery can cause brain damage:
- Prenatal disturbance of brain cell migration: Infections, environmental factors, and hereditary conditions can disrupt brain cell migration and damage brain tissue.
- Brain cell death: If brain cells die before, during, or after birth, brain damage can occur. Cell death can have many causes, such as oxygen deprivation and infection.
- Damaged brain cell synapses: The synapses in the brain allow brain cells to communicate with one another. If those synapses become damaged or severed from one another, brain injury occurs.
- Inadequate myelin: Inadequate myelin, which protects the brain cells, can cause nerve disorders and brain damage.
Physicians can detect some of these events at the time of occurrence, but this isn't always the case. Consequently, many children aren't diagnosed with cerebral palsy until months or years have passed. The diagnosis speed can depend on many factors, including the severity of the damage and its detectability during or after birth.
Explaining and Understanding How This Happened to Your Child
It's sometimes impossible to determine the cause of cerebral palsy in a child. Parents usually want to know what caused the brain damage or injury, and doctors will attempt to find the cause so they can provide more accurate treatment. Fortunately, modern medicine has provided many tools and technologies to help medical professionals trace the roots of conditions like cerebral palsy.
For instance, magnetic resonance imaging, or MRI, and computerized tomography, or CT, allow radiologists to view the brain. An MRI produces a three-dimensional image of the brain so physicians can identify the area where the brain damage occurred, while CT scans create X-rays from multiple angles so doctors can view cross-sections of the brain.
Blood tests and observational tools can also help identify the cause of cerebral palsy, but these take time. Additionally, occupational and physical therapists can work with your child to improve motor function and to better understand the affected parts of your child's body. For instance, some forms of cerebral palsy impact just the arms, just the legs, or just one side of the body. Cerebral palsy can also affect the neck and esophagus, which can make eating and drinking difficult.
Co-occurring conditions can also relate to cerebral palsy:
- Erb's palsy: Children with Erb's palsy have difficulty controlling their shoulders, arms, and hands.
- Shoulder dystocia: Shoulder dystocia occurs when the baby's shoulders get stuck in the birth canal. It can cause brain damage because it cuts off oxygen to the brain.
- Brachial plexus palsy: A condition in which there is damage to the brachial plexus nerves, which results in limited motor control in the arms.
- Klumpke’s palsy: This condition affects the baby's shoulders and wrists, typically from nerve damage.
Understanding the Terminology
If your child has cerebral palsy, you'll want to understand the terminology your doctors use to describe your child's condition.
When your baby is born, his or her brain has not yet developed fully. Cerebral palsy results from damage to a developing brain. Brain development continues in earnest through a child's third birthday, and sometimes for even longer.
A brain defect means damage has occurred to the brain or the brain has malformed in some way. Hereditary issues can cause a brain defect, as can a perinatal infection. Some defects produce serious symptoms, while others go unnoticed.
A brain malformation refers to an incorrectly formed part of the brain. It can happen before, during or after delivery.
A lesion is a defect in the brain caused by infection, asphyxiation, or other trauma. Brain lesions often create holes in the brain or diseased parts of the brain tissue.
Cerebral palsy always starts with some form of brain injury, but educating yourself about the different causes and their potential consequences will help you get the best possible care for your baby. Because cerebral palsy results from such a range of circumstances, parents depend on experienced medical teams who screen, diagnose and treat children with motor function delays