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Epistaxis (Nose Bleed)

About Epistaxis

Normally a nosebleed is nothing to worry about, but there are occasional times when this innocuous problem is a symptom of a more serious neurological disorder. If this is the case, it is likely that your primary care physician recommended that you see an endovascular neurosurgeon. This type of surgeon specializes in medical issues of the blood vessels.

Symptoms of Epistaxis

The most obvious symptom of epistaxis is blood dripping from one or both of your nostrils. If there is a blood clot involved, blood may also drip down the back of your throat. Anterior nosebleeds are the type that almost everyone experiences at least once in their lifetime, and these types of nosebleeds are usually easily controlled at home.

Posterior nosebleeds are more serious, however, and some require immediate attention from a doctor. These occur higher in the nasal cavity. It is not unusual for large amounts of blood to drip down the back of the throat. If routine first aid doesn’t stop the nosebleed, you must seek medical attention. Severe blood loss can cause cardiac problems, anemia or decrease of your overall health; therefore, it is critical that you see a physician who has the skills to diagnose and treat the issue correctly.

Diagnosing Epistaxis

The endovascular neurosurgeon will ask you questions about your medical history and perform some blood work to rule out any bleeding abnormalities that may be the cause of the problem. You may have seen an ENT doctor who did a routine nose examination, before you were referred to an endovascular neurosurgeon. In most cases, you have to see an ENT doctor who will then refer you to an endovascular neurosurgeon, or if you have very severe unstoppable nose bleeding, you may be seen by an endovascular neurosurgeon in the hospital. Nose bleeds occur more often in the winter months, and in those who are taking medications that thin the blood.

In extreme nosebleed cases, it may be necessary to perform a test where a dye is injected into the body via the blood vessels. This allows the doctor to view the vessels more clearly. This procedure is called angiography.

Some nosebleeds are a symptom of another type of condition, such as a tumor in the nasal cavity or hereditary hemorrhagic telangiectasia. Visiting an endovascular neurosurgeon helps you to receive the correct diagnosis and treatment plan.

Treatment Options for Epistaxis

Depending on the cause and location of the bleeding, the endovascular neurosurgeon will select the best option to stop the bleeding. Typically, other treatments have to be tried first such as sealing the blood vessel that experienced trauma by using an electric probe to cauterize the site, nose packs or balloons that are inserted into the nose, and/or laser therapy that uses a beam to stop the blood flow.

Surgery may also be necessary to control the epistaxis. During this procedure, the physician will tie the offending blood vessel off so that the blood flow ceases. If those methods fail or are not deemed appropriate by your ENT doctor, another method to eliminate the epistaxis is to use embolization. This is what an endovascular neurosurgeon does. This technique involves using a plug to block the blood flow in the blood vessel, and is performed through a small tube that is inserted into your groin artery and then advanced from inside your body to the site of the bleeding vessel.

Why Choose Neurosurgeons of New Jersey?

Our practice has been established and helping patients around the country for over two decades. In that time we have built a team neurosurgeons who specialize in endovascular medicine; therefore, we are fully equipped to diagnose your epistaxis problem with the latest technology and information available. Throughout the process of working with us, our compassionate and caring staff will do whatever is necessary to provide with whatever information or help you may need. The focused care that we provide to each patient shows that our number one priority is your good health.

Our Doctors Who Treat Epistaxis

Dr. Dorothea Altschul


Dr. Ahsan Sattar