Brain injuries resulting from stroke and trauma are common and costly in human and resource terms. In England, approximately 130,000 people have a stroke each year, of whom about one-quarter die and half of the survivors are left dependent on others.1 The incidence of head injury is similar to that for stroke,2 although the incidence of death is lower, at 6–10 per 100,000 population per year.3 However, head injury is more common in younger people, and it has been estimated that 4700 of those admitted to hospital each year would be unable to return to work at 6 weeks.2 A Scottish study found that 78% of patients with a severe injury had moderate or severe disability 1 year later