I cannot be of much help because I am not a doctor and I am not familiar with the problem you described. But I found this doctor's response to someone who posted on the Doctor-to-Patient Asthma and Allergy Forum on 5/23/07. You can find it at http://www.medhelp.org/forums/Asthma-Allergy/messages/53.html. The person asked about headaches and nosebleeds. The doctor responded:
"It is most likely that the nose bleeds and headaches are unrelated. But both headaches and nose bleeds could be caused by a problem with your blood not clotting properly. In this case, you might bruise easily, bleed a lot from a small cut and have bleeding from your stomach or intestine. If the nose is the only place you have bleeding, a clotting disorder is unlikely. There a simple blood tests your doctor can order to see if poor blood clotting is the problem.
There is an association between Migraine Headaches and nose bleeds, seen most commonly in children. This could however also occur in adults and, since Migraine Headache is a very common condition, you might want to ask your doctor to check this out first.
If neither of the above is the answer, there is another possibility. A different type of inherited disorder that can involve blood vessels of the lungs (most commonly), skin and even the brain. These are called arterio-venous malformations (AVM's) and are uncommon but not rare. One of these is called HHT. You would have to ask your doctor about this and it might be necessary for you to see a Neurologist. You will probably need to have a CT Scan of your brain to evaluate your brain for this problem and other problems that could cause headaches."
It sounds like a clotting disorder might have been ruled out in your girlfriend's case, if they included it in the blood analysis.
The scan of the brain might have ruled out the AVM, perhaps depending on the type of scan your girlfriend had. By the way, I take it that your girlfriend has not experienced any head trauma recently?
It sounds to me like there are known associations between headaches and nose bleeds, so perhaps you and your girlfriend need to see a different neurologist!
I don't know what to think about the doctor pressing on the back of your girlfriend's head and making her nose bleed instantly.
My sister had surgery to lift up the descended part of her brain. By the time she was diagnosed (3-4 years after the onset of her headache), she had developed numerous other neurological problems, although the headache was her first symptom. The surgery resolved her headache and some of the neurological issues. However, she has continued to have serious problems (for example, pituitary dysfunction), although it is unclear if it is related or unrelated to the original Chiari malformation and/or to the surgery.
As I understand it, a person is generally born with the Chiari malformation, but it may not cause problems until adulthood, if ever. I think my sister was around 25 or 26 years old when she first got sick. She is 37 now.
Generally, a diagnosis of Chiari malformation is not made without evidence from an MRI that the brain is descended. You girlfriend might want to have an MRI of the brain stem to verify your Family Practitioner's diagnosis, if it wasn't seen on the original scan, and consult with another neurologist.
You might also look online for Chiari malformation forums, support groups, or chat rooms. I'm pretty sure they exist, I recall my sister mentioning them. Or make another post to this forum and ask specifically about Chiari malformation.
By the way, I think there are different types of Chiari malformations, and maybe the treatment is different for the different types.
Headaches are common with Chiari, nosebleeds is a new addition to me. I have the Chiari malformation, but not Chiari (my malformation is extremely minor). It sounds more to me like HHT, as was mentioned above. If she fits into the diagnostic criteria below, I would ask for another opinion. It is possible that the Chiari malformation in causing the headaches but not the bleeds.
CLINICAL DIAGNOSTIC CRITERIA FOR HHT
1. 1. NOSEBLEEDS, spontaneous and recurrent.
2. 2. TELANGIECTASES, multiple, at characteristic sites including lips, oral cavity, fingers and nose.
3. 3. INTERNAL LESIONS such as
1. Gastrointestinal telangiectasia (with or without bleeding)
2. Pulmonary AVM
3. Hepatic AVM
4. Cerebral AVM
5. Spinal AVM
4. 4. FAMILY HISTORY- a first degree relative with HHT according to these criteria.
The HHT Diagnosis is:
- Definite if 3 criteria are present
- Possible or suspected if 2 criteria are present
- Unlikely if fewer than 2 criteria are present.
Hi I have recently been having really bad headaches/migranes constantly every day and bleeding from the nose.
I have been to the doctors but they said it was just a FLU but i have never been in so much pain before hand, i was wondering if anyone had any responses to this as i am and family members are getting worried as i am on 16 years old
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