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How is the cause of a TBI determined and how sure can doctors be of the cause?

My friend drove into a big hole and was fine for a month or so. Then he had an altered medical status problem due to a subdural hematoma and a traumatic brain injury was diagnosed and doctors said it was because he drove into the pothole.  He is in his 70s and used narcotics until about two years before driving into the pothole. Can doctors really know the cause?
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973741 tn?1342342773
Hm, not really sure except that I'd guess an injury that is traumatic looks different on brain imagery than long term issues from drug use.  How is your friend now?
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