Neonatal arterial ischemic stroke (NAIS) is the most common form of stroke in children, potentially leading to long-term neurologic sequelae, including cerebral palsy (CP), epilepsy, cognitive impairment, and behavioral problems. Predicting outcomes of NAIS is a challenge. One child with NAIS may have significant impairment, whereas another with a similar infarct may be almost asymptomatic. A tool that could predict a child’s outcome based on infarct characteristics (location and volume) would be a powerful aid in the clinic. Multiple studies have shown that infarct characteristics can predict motor impairment such as CP; however, most of these did not use the most sophisticated and sensitive imaging techniques.1-3 The correlation between language and cognitive skills has been less clear.