Forty-four young adults, admitted to a rehabilitation centre after very severe head injury, were followed-up 2 years after their accident. Comparison with a control group showed that the head injuried had experienced marked changes in work, leisure activities, contact with friends and family life. Though these changes still created problems, the majority of patients and relatives appeared to have made a number of successful adaptations to their altered situation. Neurophysical status, personality change and memory loss all affected work capacity, while presence of personality changes was especially important in the loss of pre-accident friendships.