We report a term infant who presented with focal seizures and was diag
nosed with a large left hemispheral infarct. Evaluation revealed exten
sive fetomaternal hemorrhage and subsequent neuroimaging disclosed a c
lassic border zone infarct consistent with a hypoperfusion injury. We
postulate that fetomaternal hemorrhage should be considered in the dif
ferential causation of neonatal stroke. The unilaterality of the lesio
n in this patient is difficult to explain.