Damage to orbital frontal cortex is common following traumatic brain injury, even minor head injuries. The medical consequences of such an injury can be relatively trivial, but can have potentially catastrophic consequences on psychosocial competency, ability to maintain employment, reliable disposition of activities of daily living, and so called executive functioning. These major problem areas have proven elusive to standard neuropsychological testing, and can coexist with high intelligence quotient (IQ) test scores. Close interview of collateral informants (individuals familiar with the head injured patient in “real life” activities) can prove a valuable source in identifying and documenting these important neuropsychiatric and psychological sequelae of closed head trauma.