OBJECTIVES: The first objective of this study was to examine the extent to which the results of the visual interpretation of brain single photon emission computed tomography (SPECT) images correspond with those of SPM analysis in patients with traumatic brain injury (TBI). The second objective was to explore the possibility of the clinical application of SPM analysis for finding the brain lesions related to the neuropsychiatric symptoms, of which the patients complained. METHODS: SPECT images from 10 TBI patients (all male, mean age: 46.8+/-12.32) and 10 age- and sex-matched control subjects were interpreted by an experienced radiologist. Their SPECT images were also analyzed by SPM2 software for comparing the individual images with the controls. RESULTS: The results of visual interpretation of SPECT images generally corresponded with those of SPM analysis in five of the 10 TBI cases. In the remaining cases, brain lesions not identified from visual interpretation were found through SPM analysis. The location of these lesions included the anterior cingulate gyrus, caudate nucleus, thalamus, and subcallosal gyrus. SPM analysis also made it easy to find brain hypoperfusion areas associated with the TBI patients' neuropsychiatric symptoms. CONCLUSION: This study suggested possible clinical applications of SPM analysis of SPECT data from patients with TBI. Its advantages and limitations were discussed.