Head Injury with Blood in Nasal Mucus: When to Seek Neurological Care?

Head injury with blood in nasal discharge?

Hello, doctor.
I accidentally bumped the left back of my head against the edge of a table while picking something up.
A minute later, when I blew my nose, I noticed a little blood coming from my left nostril, but it stopped after two times.
The area of impact isn't very painful, and about five minutes later, I couldn't feel where I hit anymore.
Should I observe this for a day or two, or do I need to see a neurosurgeon?

Max, 40~49 year old female. Ask Date: 2024/01/10

Dr. Zhao Shaoqing reply Neurosurgery

You can continue to observe your condition.
If you experience any discomfort or bleeding, please visit the outpatient clinic.
The Changhua Hospital of the Ministry of Health and Welfare cares about you.

Reply Date: 2024/01/10

More Info

When it comes to head injuries, particularly those involving a potential for intracranial bleeding, it is crucial to be vigilant about symptoms and seek appropriate medical care when necessary. In your case, you experienced a minor head injury after hitting the back of your head against a table edge, followed by a small amount of blood from your left nostril. While the injury may seem minor, there are several factors to consider regarding the need for neurological evaluation.

Firstly, the presence of blood in the nasal mucus after a head injury can be concerning. It may indicate a possible fracture of the skull base, particularly if the blood is clear or mixed with cerebrospinal fluid (CSF). This condition, known as rhinorrhea, can occur when there is a breach in the protective barriers of the brain, allowing CSF to leak into the nasal cavity. Although you mentioned that the bleeding was minimal and stopped after a couple of instances, it is still essential to monitor for any additional symptoms.

Here are some key symptoms to watch for that would warrant immediate medical attention:
1. Persistent or Worsening Headache: If you develop a headache that does not improve or worsens over time, it could indicate increased intracranial pressure or bleeding.

2. Nausea or Vomiting: These symptoms can be signs of increased pressure in the skull or other complications.

3. Dizziness or Confusion: If you experience disorientation, difficulty concentrating, or any changes in your mental status, it is crucial to seek medical help.

4. Changes in Vision or Hearing: Blurred vision, double vision, or hearing changes can indicate neurological issues that need to be evaluated.

5. Seizures: Any seizure activity following a head injury is a medical emergency.

6. Weakness or Numbness: If you notice weakness or numbness in any part of your body, this could be a sign of a serious injury.

7. Fluid Leakage from Nose or Ears: If you notice clear fluid leaking from your nose or ears, this could indicate a CSF leak, which requires immediate evaluation.

Given that you experienced a minor head injury with some nasal bleeding, it is advisable to err on the side of caution. While it may be tempting to wait and observe for a day or two, if any of the above symptoms develop, you should seek neurological care promptly.
In terms of observation, if you choose to monitor your condition, ensure that you have someone with you who can help assess any changes in your symptoms. If you feel uncertain or anxious about your condition, it is always better to consult a healthcare professional for peace of mind.
In summary, while your injury may not seem severe at first glance, the potential for complications exists. If you experience any concerning symptoms or if the bleeding resumes, do not hesitate to seek medical attention from a neurologist or visit the emergency room. Your health and safety are paramount, and timely intervention can make a significant difference in outcomes following head injuries.

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