Brutal youth needs a voice. Most often it is best heard as the inarticulate roar of "Fuck you!" over the pain-inducing beat of loud music badly played by low-life hoodlums. Sometimes a talented actor or actress can latch on to their lizard brain and replicate the results on screen. It is all too rare that a writer can capture that lack of conscience, the incredible ego, and the lust for life and death that raging hormones and a bad attitude cough up. 'Head Injuries', the low-key high-voltage debut by Conrad Williams manages to hover over the same abyss as the disaffected youth it portrays. The reader cannot help but join the characters, who have been gazing downward far too long to look away.

The novel begins with a disturbing, surreal vision of schoolyard bullies, then takes up the story David, Helen and Seamus, three antagonistic friends who come together some five years after leaving school. Together, they've been through most of the permutations of friends and lovers. Now, they are three amateur artists with cruddy jobs, bad prospects and too much time on their hands. They all feel that they're being followed, that whatever or whoever is following wants them to be together. If this all sounds a bit grim, Williams injects just enough humor to keep things from falling into the "Why don't I just kill myself and get it over with?" syndrome.

Where 'Head Injuries' really shines is in Williams' surreal explorations, as the characters dream, hallucinate and actually witness events that would seem beyond description but for the words that Williams puts on the page. He manages to inject the most delicate objects and images with a deep, abysmal terror, while seemingly very little is actually happening. But Williams' visions are striking enough to keep the reader riveted.

It's no accident that Ramsey Campbell provides a cover blurb for 'Head Injuries'. The territory that Williams treads has analogues in Campbell's work and Dennis Etchison's tales or suburban angst. But Williams phantasms are all his own, and his characters are the sort of surly types that Etchison's and Campbell's would surely seek to avoid if they were to pass on the street.

'Head Injuries' is an outstanding debut novel, from a new publisher that promises to be the source of more interesting material. The novel is attractively packaged and low-priced. This is clearly one of the best first novels by a horror writer to appear this year.