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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Headache Followed By Nose Bleed In A 15 Year Old?

i have a question about my 15 year old son he started having migraines when he was 11. They have gotten worse the past couple years. Our eye doc diagnosed occular migraines. He has had a ct scan to rule out other causes. Family Doc suggested imitrex. Today is the first time I tried it when my son stated he was getting a headache. I gave one tablet at 7pm and one at 9pm. He fell asleep shortly after the first dose. He woke stating his head still hurt. i guess my big concern now is that he stated that today 3 times during the school day he felt a sharp pain in his head followed by a nosebleed. Do you think we are missing something? Where should I go with this? Thank you in advance! Peggy
Fri, 27 May 2022
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General Surgeon 's  Response
Hi,

Severe headache in a boy of 15 with nose bleed can be due to hypertension is missed as no one thinks of it in an young boy. Vascular malformation in or around brain. Proper clinical evaluation particularly blood pressure, neurological examination. MRI Angiography or Digital Subtraction Angiography (DSA) should help to get a proper diagnosis. Once a diagnosis is done, you can consult a related Specialists and go ahead with specific treatment.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. T. Chandrakant, General Surgeon
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General Surgeon Dr. T Chandrakant's  Response
Hi,

Headache with nosebleed together should be seen as an urgent and serious problem. The commonest causes are hypertension, any vascular malformation in the front area of skull or brain.

Get an ENT Endoscopy by an ENT Surgeon with an MRI angiography associated with CT scan of nose, sinuses, base of scull, and brain. Any other tests as would be advised. All these will lead to a probable or definite diagnosis hence a specific treatment can be given.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. T. Chandrakant, General Surgeon
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What Causes Severe Headache Followed By Nose Bleed In A 15 Year Old?

Hi, Severe headache in a boy of 15 with nose bleed can be due to hypertension is missed as no one thinks of it in an young boy. Vascular malformation in or around brain. Proper clinical evaluation particularly blood pressure, neurological examination. MRI Angiography or Digital Subtraction Angiography (DSA) should help to get a proper diagnosis. Once a diagnosis is done, you can consult a related Specialists and go ahead with specific treatment. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. T. Chandrakant, General Surgeon