More than 20 years after severe head injury the preliminary results of the present study indicate that the very late psychosocial outcome differed much in the individual subjects. The most decisive negative factors were severely disturbed behaviour and lack of insight. Improvement many years after injury was, however, possible. During the years the relationship between parent(s) and severely head injured sons often became strained. After the first posttraumatic year or two the patient with severe behavioural deficits must be helped to adopt some other type of living.