Managing Post-Concussion Symptoms: Nosebleeds and Ear Noises Explained - Neurology

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After a concussion, it is not uncommon for patients, especially children, to experience a variety of symptoms as they recover. Your child's symptoms of nosebleeds and the sensation of water in the ear can be concerning, but they may not necessarily indicate a serious issue. Here’s a breakdown of what might be happening and what steps you should consider taking.


Understanding the Symptoms
1. Nosebleeds: After a concussion, nosebleeds can occur for several reasons. The trauma from the accident may have caused minor damage to the nasal passages or sinuses, leading to bleeding. Additionally, if your child has been experiencing any nasal congestion or dryness, this could also contribute to nosebleeds. It's important to monitor the frequency and severity of these nosebleeds. If they are frequent or heavy, it would be advisable to seek medical attention.

2. Ear Noises: The sensation of water or noises in the ear can be attributed to several factors. After a concussion, changes in pressure within the ear or Eustachian tube dysfunction can occur. This can lead to feelings of fullness or sounds that resemble water sloshing around. This symptom is often benign and may resolve on its own as your child continues to heal. However, if your child experiences pain, significant hearing changes, or persistent symptoms, further evaluation may be necessary.


When to Seek Medical Attention
Given that your child has already been evaluated and cleared of any immediate concerns, it may not be necessary to rush back to the emergency room unless new or worsening symptoms develop. However, you should definitely consider the following:
- Monitor Symptoms: Keep a close eye on your child’s symptoms. If the nosebleeds become more frequent, if the ear noises worsen, or if new symptoms such as severe headaches, confusion, or changes in behavior arise, you should seek medical attention immediately.

- Follow-Up Appointment: If the symptoms remain stable and do not escalate, it would be reasonable to wait for the scheduled neurosurgery outpatient appointment. However, if you feel uncertain or if your child expresses discomfort, it’s always better to err on the side of caution and consult a healthcare professional sooner.


Traveling by Air
Regarding air travel, it is generally safe for individuals recovering from a concussion to fly, provided they are stable and not experiencing significant symptoms. However, the changes in cabin pressure during takeoff and landing can exacerbate ear discomfort, especially if there is any Eustachian tube dysfunction. Here are some tips if you decide to fly:
- Ear Pressure Relief: Encourage your child to yawn, swallow, or chew gum during takeoff and landing to help equalize ear pressure. If they have a cold or nasal congestion, it might be wise to postpone travel until they are feeling better.

- Hydration: Ensure your child stays well-hydrated before and during the flight, as this can help with overall comfort and may reduce the likelihood of nosebleeds.


Conclusion
In summary, while your child's symptoms of nosebleeds and ear noises following a concussion can be concerning, they may not necessarily indicate a serious problem. Monitor the symptoms closely, and if they worsen or new symptoms arise, seek medical attention promptly. If all remains stable, waiting for the follow-up appointment is reasonable. As for flying, ensure your child is comfortable and follows the tips mentioned to manage ear pressure. Always prioritize your child's health and well-being, and don't hesitate to seek help if you have any doubts.