A case study is presented in which a patient received magnetic resonance (MR) imaging of the brain 3 months prior to a severe traumatic brain injury (TBI). The post-TBI MR findings are compared and contrasted with the pre-TBI MR images. The posttraumatic changes demonstrate a significant dilation of the ventricular system which reflects diffuse axonal injury and loss of brain substance. Correspondingly, the neuropsychological studies in this individual reflect global deficits which match the nonspecific, traumatically induced degenerative changes found in the postinjury MR scan. This case study is unique in that specific preinjury MR findings are available for direct comparison and quantitative analysis of TBI-associated changes in brain structure with neuropsychological outcome.