Nosebleed

Epistaxis, more commonly known as a nosebleed, is a frequent medical occurrence characterized by hemorrhage (bleeding) from the nostrils, nasal cavity, or nasopharynx. Despite the fact that it can cause anxiety due to the visible nature of the bleed, it is usually benign and can be managed effectively with simple first aid measures.

Etiology

Epistaxis can occur as a result of numerous factors. However, it is most often attributed to one of two sources:

• Local factors such as dryness of the nasal mucosa, trauma (including nose-picking), infections, use of topical nasal medications, nasal inhalation of illicit substances, and abnormalities in the structure of the nasal septum.
• Systemic factors such as hypertension (high blood pressure), blood clotting disorders (like hemophilia and Von Willebrand disease), use of anticoagulants or antiplatelet agents, alcohol abuse, and certain inherited conditions.

Anatomy

From an anatomical perspective, nosebleeds are classified as either anterior or posterior, depending on the source of the bleed.

• Anterior nosebleeds are more common, accounting for nearly 90% of cases, and originate from 'Kiesselbach’s plexus', a network of vessels in the anterior part of the nasal septum.
• Posterior nosebleeds are typically more severe and originate from the branches of the sphenopalatine artery in the posterior nasal cavity.

Management

For the majority of nosebleeds, simple first aid measures are sufficient to control bleeding. This includes leaning slightly forward (to prevent blood from going down the throat), pinching the nostrils together, and applying a cold compress to the nose. If bleeding continues for more than 15 minutes, or is heavy and associated with symptoms like dizziness, it's necessary to seek immediate medical attention.

In more severe or persistent cases, medical intervention may be required. This could involve cauterization of the bleeding vessel, nasal packing, or in rare cases, surgical intervention or arterial ligation.

See Also

• Hemorrhage
• Hypertension
• Hemophilia
• Von Willebrand disease

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