Day-of-injury computed tomographic scans were compared with postinjury magnetic resonance imaging of 38 patients with traumatic brain injury. Ventricles and several white and gray matter structures were measured. Results demonstrated significant changes in ventricular sizes and all measures of white matter. Changes in gray matter were nonsignificant, except in the putamen/globus pallidus. Patients were grouped according to ventricular change, and neuropsychological outcome was examined. The group with the highest ventricular change had significantly lower memory scores but did not show significant differences on tests of intellectual functioning. A three-dimensional image analysis was performed to enhance visualization of the injured brain.