Can a Concussion Cause a Nosebleed? What Athletes, Coaches, and Parents Need to Know

Although concussions rarely cause nosebleeds, impact-induced facial trauma can cause bleeding in the nasal passages. The presence of a nosebleed can sometimes be a sign of a more serious injury, such as a fractured skull.

A study on facial injuries confirms that nosebleeds following a head impact are more often linked to direct trauma to the nose or face rather than the concussion itself [Facial Injuries]. 

Another study on head injuries emphasizes that while concussions do not inherently cause external bleeding, nasal bleeding after trauma could signal a more serious underlying issue like a skull or sinus fracture [Head Injuries—I].

This article breaks down the connection between concussions and nosebleeds, when to be concerned, and how to respond effectively.

Can a Concussion Cause a Nosebleed?

Concussion alone does not cause a nosebleed, but an impact strong enough to cause a concussion can also injure the nose or surrounding structures, leading to bleeding.

Common Causes of Nosebleeds After Head Trauma:

  1. Direct Nasal Trauma – A hit to the face can rupture blood vessels inside the nose, resulting in a nosebleed. This is common in sports like football, basketball, and soccer [Facial Injuries].
  2. Sinus or Nasal Bone Fractures – High-impact collisions can break nasal bones or damage the sinuses, leading to bleeding [Mechanisms of Head Injury].
  3. Increased Blood Pressure from Trauma Response – After a concussion, the body’s physiological response can increase blood pressure, making small nasal injuries bleed more than usual [Factors of Importance in Head Injury].
  4. Skull Fractures (Rare but Serious) – While not common, certain skull fractures, especially basilar skull fractures, can cause nasal bleeding. These injuries require urgent medical attention [Concussion].

A study on professional football concussions found that players who experienced concussions often had accompanying facial injuries—including broken noses—which contributed to nosebleeds, rather than the concussion itself [Concussion in Professional Football].

In short, if a nosebleed occurs after a head injury, it’s likely due to facial trauma rather than the concussion itself. However, there are cases where it could signal a more serious issue.

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When to Be Concerned: Signs of a More Severe Injury

Most nosebleeds after a head impact are minor and stop with basic first aid. However, certain red flags indicate the need for immediate medical attention.

Signs That Require Urgent Medical Attention:

  • Uncontrolled bleeding – If a nosebleed lasts longer than 15 minutes, despite applying pressure [Head Injury].
  • Blood mixed with clear fluid – This could indicate a cerebrospinal fluid (CSF) leak, a sign of a skull fracture [Concussion].
  • Facial swelling or deep bruising – Suggests a possible nasal or sinus fracture [Mechanisms of Head Injury].
  • Loss of consciousness or worsening confusion – Can indicate a serious brain injury rather than just a concussion [Head Injuries—I].
  • Double vision or difficulty moving the eyes – A possible sign of a basilar skull fracture [Factors of Importance in Head Injury].
  • Persistent nausea, vomiting, or severe headache – Could indicate intracranial bleeding, requiring immediate evaluation [Head Injury].

A study on intracranial bleeding highlights that nosebleeds accompanied by ear bleeding, vomiting, or loss of consciousness increase the likelihood of a severe injury [Concussion].

When a Nosebleed is Likely Not Serious:

  • The bleeding stops within a few minutes after applying gentle pressure.
  • No swelling or visible injury to the face.
  • No other symptoms (e.g., no dizziness, vision problems, or persistent headache).

Even in minor cases, it’s always good practice to monitor for delayed concussion symptoms and seek medical evaluation if any concerns arise.

What to Do if a Nosebleed Occurs After a Head Injury

A nosebleed following a head injury can be alarming, but in many cases, it is the result of direct trauma to the nose rather than the concussion itself. 

However, knowing how to respond properly is crucial to rule out serious complications and ensure the athlete’s safety.

The first step is to stay calm and assess the situation. If the athlete remains conscious, alert, and does not display any concerning symptoms, the nosebleed can likely be managed with simple first aid. The standard approach is to have the individual sit upright, lean forward slightly, and apply firm pressure to the soft part of the nose for 10 to 15 minutes. This helps minimize blood flow and encourages clotting. Ice can also be applied to reduce swelling, especially if there is visible nasal trauma.

However, if the nosebleed persists beyond 15 minutes or if bleeding is heavy, medical attention may be necessary. 

Trainers and parents should ensure that an athlete is properly evaluated for a concussion and any underlying facial injuries before considering a return to play. Even if the nosebleed stops quickly, facial trauma may indicate additional injuries that are not immediately obvious. 

Post-injury monitoring is critical. Even mild concussions require careful observation for delayed symptoms. A stepwise return-to-play protocol ensures full recovery before resuming activity.

A concussion alone doesn’t cause nosebleeds, but facial trauma during impact can. Most nosebleeds are minor, but persistent bleeding or additional symptoms may indicate a more serious injury. 

Protective gear, proper recovery, and medical evaluation when needed help keep athletes safe.

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