The effect on neuropsychological outcome of the number of acute haemorrhages, lesion volume, and lesion location in traumatic brain injury (TBI) was evaluated. Haemorrhagic lesion volume was associated with severity of injury. However, the number of petechial haemorrhages was not reliably associated with any of the clinical outcome measures. Likewise, despite the use of detailed morphometric methods to quantify volume, the acute lesion size did not significantly relate to neuropsychological sequelae. Furthermore, brain quadrant localization methods did not enhance outcome prediction. These results are discussed in the context of acute lesion analysis contrasted with chronic TBI-induced neuropathological changes associated with neuropsychological outcome.