Head Injury and Nosebleeds: When to Seek Medical Attention

After hitting the head, suddenly experiencing a nosebleed?

Hello Dr.
Chuang: A couple of days ago, I accidentally hit my head.
At the time, I didn't feel any particular pain, but a few minutes later, I noticed blood in my nasal mucus.
Recently, I've also been waking up feeling very dizzy and often have headaches.
Could this be related to the impact on my head? Should I seek medical attention? Thank you.

Miao, 20~29 year old female. Ask Date: 2008/04/29

Dr. Zhuang Yumin reply Neurology

Nasal discharge with blood, along with dizziness and headaches, may be symptoms of a nasopharyngeal lesion.
You should first visit an otolaryngologist for an examination to determine the cause of the bloody nasal discharge.
If there are any specific findings, you may need to see a neurologist.
In some cases, severe head trauma can also lead to cerebrospinal fluid leakage into the nasal cavity.

Reply Date: 2008/04/29

More Info

Head injuries can be concerning, especially when accompanied by symptoms such as nosebleeds, headaches, and dizziness. In your case, the fact that you experienced a nosebleed shortly after the head injury and are now experiencing persistent headaches and dizziness warrants careful consideration.

Firstly, it's important to understand that a head injury can lead to various complications, including intracranial bleeding, which can manifest in different ways. The presence of blood in your nasal discharge could indicate a few possibilities. One potential cause is a fracture in the skull, particularly in the area of the nasal cavity, which can lead to bleeding from the nose. This is often referred to as "rhinorrhea" when cerebrospinal fluid leaks through the nose, which can happen in more severe cases of head trauma.
The symptoms of dizziness and headaches that you are experiencing could indeed be related to the head injury. After a head trauma, it is not uncommon for individuals to experience post-concussive symptoms, which can include headaches, dizziness, confusion, and difficulty concentrating. These symptoms can arise even if the initial injury did not seem severe.
Given your symptoms, it is advisable to seek medical attention. Here are some reasons why:
1. Assessment of Injury Severity: A healthcare professional can perform a thorough evaluation, including a neurological examination, to assess the severity of your injury. They may recommend imaging studies, such as a CT scan, to rule out any serious complications like a concussion or intracranial hemorrhage.

2. Monitoring Symptoms: Persistent headaches and dizziness can indicate that your brain is still recovering from the injury. A doctor can provide guidance on managing these symptoms and determine if further treatment is necessary.

3. Preventing Complications: Early intervention can help prevent potential complications that may arise from head injuries. If there is any bleeding or swelling in the brain, timely medical intervention is crucial.

4. Guidance on Recovery: A healthcare provider can offer advice on how to manage your symptoms and when it is safe to return to normal activities. They can also provide recommendations for follow-up care if needed.

In summary, while not every head injury results in serious complications, the combination of your symptoms—particularly the nosebleed, persistent headaches, and dizziness—suggests that you should seek medical attention as soon as possible. It is always better to err on the side of caution when it comes to head injuries. Your health and safety are paramount, and a medical professional will be able to provide the appropriate care and guidance tailored to your situation.

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