This report describes outcomes for a group of 26 children who remained unconscious longer than 90 days after traumatic brain injury. Twenty children regained consciousness; 11 are able to communicate. Five children can ambulate independently. In this series, children with the best recovery (IQ greater than or equal to 70) were predicted by minimal cerebral atrophy, demonstrated by computerized brain scan (CT scan) performed two months after injury (p = 0.001). In subjects over 12 years old, minimal CT atrophy predicted a good outcome with 89% accuracy.