Measurements of the ventricular brain ratio (VBR), width of the sylvian fissure, and symmetry of the frontal lobes were obtained from 26 chronic schizophrenic patients, 22 alcoholic and neurological patients, and 20 normal controls. All schizophrenic subjects were non-responsive to long-term neuroleptic medication for 3-25 yr and were between 23 and 45 yr of age. Detailed diagnostic workups differentiated two sub-groups by DSM III criteria, residual and paranoid. The former group was characterized by large VBRs while the paranoids were within the range of normal controls. Those patients with VBRs greater than nine had wider sylvian fissures and increased frequency of reversed frontal asymmetry. As a group, the VBRs of all schizophrenics differed significantly from normal controls but did not differ from those of alcoholics or patients with neurological disorders (migraine, generalized seizures). This finding indicates that DSM III criteria applied to CT scan measures may help define a sub-group within the schizophrenias. While not specific to this disorder, the underlying pathology demonstrating increased VBRs and other CT scan changes may be specific to but different from other disorders.