While closed head injury frequently results in damage to the frontal and temporal lobes, damage to deep cortical structures, such as the hippocampus, amygdala, and basal ganglia, has also been reported. Five deep central structures (hippocampus, amygdala, globus pallidus, putamen, and caudate) were examined in 16 children (eight males, eight females; aged 9-16y), imaged 1 to 10 years after moderate-tosevere traumatic brain injury (TBI), and in 16 individuallymatched uninjured children. Analysis revealed significant volume loss in the hippocampus, amydala, and globus pallidus of the TBI group. Investigation of relative volume loss between these structures and against five cortical areas (ventromedial frontal, superomedial frontal, lateral frontal, temporal, and parieto-occipital) revealed the hippocampus to be the most vulnerable structure following TBI (i.e. greatest relative difference between the groups). In a separate analysis excluding children with focal hippocampal abnormalities (e.g. lesions), group differences in hippocampal volume were still evident, suggesting that hippocampal damage may be diffuse rather than focal.Although frontal and temporal areas have been considered most susceptible to focal injury following traumatic brain injury (TBI), deep central brain structures, such as the hippocampal/amygdalar complex and the basal ganglia, are also vulnerable to TBI-related injury. Structural neuroimaging studies of adult patients with TBI, using T 2 -weighted fast field echo (FFE), 1 T 2 -weighted 2 and susceptibility-weighted 3 gradient echo imaging pulse sequences, have recently identified increased evidence for diffuse axonal injury and 'microbleeds' in the basal ganglia and medial temporal lobes. Similarly, functional neuroimaging has implicated deep central areas, with evidence of long-term reduction in cerebral blood flow, 4 hypoperfusion, 5 and decreased cerebral metabolic rate 6 in the basal ganglia/striatum following TBI. Medial temporal lobe vulnerability is also suggested by positron emission tomography and single-photon emission computed tomography, 7 with an association between brain injuryinduced abnormalities and neurocognitive deficits. Finally, proton magnetic resonance spectroscopy has revealed a significantly decreased N-acetylaspartate/choline ratio in the basal ganglia and hippocampus of patients with TBI. 8 Quantitative magnetic resonance imaging (MRI) studies of adult patients with TBI have found hippocampal atrophy which correlated with injury severity as measured by the Glasgow Coma Scale score. 9-12 However, only three studies have examined hippocampal volume in individuals experiencing TBI as children or adolescents, [13][14][15] and only a single study has examined caudate volume in this population. 14 Despite growing evidence of injury to the amygdala and the basal ganglia from various mechanisms, there has been no examination of the amygdala, globus pallidus, or putamen using quantitative brain imaging in pediatric patients with TBI. This absence is notable, given that thes...