Abnormal profiles of polyunsaturated fatty acids in the plasma phospholipid fraction were observed in 14 patients with hyper metabolism due to severe isolated closed head injury. Depressed linoleic acid levels were observed within 24 hours along with elevation of oleic acid levels. By one week postinjury, subnormal levels of arachidonic acid were also observed. These data indicate that the metabolic response to injury encompasses changes in the metabolism of polyunsaturated fatty acids which are rapid in onset and qualitatively similar to those seen in mild essential fatty acid deficiency.