Traumatic brain injury, a prevalent health problem in contemporary society, poses complex adaptational challenges for victims’ families. The sequelae most disruptive to family functioning appear to be residual psychiatric symptoms. With a peak incidence among young adults, brain trauma also befalls many parents of dependent children; these children are vulnerable to subsequent emotional and behavioral difficulties. An approach to these problems must recognize the broad spectrum of clinical outcomes from brain injury. Valuable insights may also be gained from earlier work on children's responses to more familiar parental psychiatric disorders. Three case reports of children with head-injured parents are presented, followed by a discussion of treatment considerations for this emerging “at-risk” population.