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Can epistaxis or nosebleeds be a of cause death?

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if u have a bleeding disorder, then – The Last Word Jul 21 '14 at 11:04
Can you explain a little bit? – Devashish Das Jul 21 '14 at 11:15
Great image choice. – basher Jul 21 '14 at 13:52
I have heard of it happening: A small kid is hit in a pretty minor traffic accident. The impact caused a nosebleed and knocked him on his back. The impact with the ground knocked him out. Head injury--they waited for the paramedics. The kid drowned. – Loren Pechtel Jul 21 '14 at 20:47
Well if you are driving at the time and have a car crush due to thinking about the nosebleed... – Ian Ringrose Jul 21 '14 at 21:24
up vote 10 down vote accepted

Yes, it can, but it is extremely rare.

... nosebleeds are rarely fatal, accounting for only 4 of the 2.4 million deaths in the U.S. in 1999 [1].

The main issue is that epistaxis can be a sign of potentially fatal diseases:

The instances in which nosebleed is potentially fatal are those in which there is a history of recent head injury, severe arteriosclerotic cardiovascular disease or an underlying vascular tumor in the nasal chambers. Fatal nasal bleeding has not been reported in children [2].

Here are some causes which can lead to fatal complications if left untreated [3]:

  • Leukaemia
  • Hypertension
  • Coagulation disorders
  • Hepatitis
  • Head injury
  • Myelodysplastic syndromes - Epistaxis

Death by massive hemorrhage can occur when epistaxis is the result of a ruptured aneurysm [4, 5, 6]:

An instance of fatal epistaxis is reported in a patient with an unsuspected aneurysm of the infraclinoid portion of the internal carotid artery. There was no known history of trauma. The aneurysm was subsequently detected on an old X-ray film. Epistaxis from an aneurysm at this site is nearly always preceded by significant head trauma and is associated with cranial nerve palsies, a syndrome with a high mortality. Epistaxis from rupture of a non-traumatic aneurysm is very rare [4].


  1. Work Table I. Deaths from each cause by 5-year age groups, race and sex: US, 1999 Page 1922. U.S. Centers for Disease Control Published 2001-05-11. Via Wikipedia contributors, "Nosebleed," Wikipedia, The Free Encyclopedia, (accessed July 21, 2014).
  2. QUINN FB. Fatal epistaxis. Calif Med. 1961 Feb;94:88-92. PubMed PMID: 13738727.
  3. Right Diagnosis (tm). Epistaxis Deaths. Available from (accessed 21.07.2014)
  4. HORNIBROOK, J. and RHODE, J. C. (1981), FATAL EPISTAXIS FROM AN ANEURYSM OF THE INTRACRANIAL INTERNAL CAROTID ARTERY. Aust. N.Z. J. Surg., 51: 206–208. doi: 10.1111/j.1445-2197.1981.tb05942.x
  5. P. N. Pathak (1972). Epistaxis - due to ruptured aneurysm of the internal carotid artery. The Journal of Laryngology & Otology, 86, pp 395-397. doi:10.1017/S0022215100075423.
  6. Urso-Baiarda F, Saravanappa N, Courteney-Harris R. An unusual cause of massive fatal epistaxis. Emerg Med J. 2004 Mar;21(2):266. PubMed PMID: 14988378.
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Any injury, that results in external bleeding can lead to death, since it is a breach in the body's defenses and an entry point for pathogens.


When you have nose bleeding the blood must be coming from somewhere. Usually from inside your body.

That means there is a hole in your body which is big enough for blood to stream out.

That in return also means that through the same hole things can get back inside your body.

For example any kind of virus or bacteria.

That does not mean every bleeding is potentially lethal. But depending on the environment the body is in the chance of infection is certainly greater with a lesion (hole in the circulatory system) than without it.

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Good Answer, Can you explain a little bit? – Devashish Das Jul 21 '14 at 11:32
Thanks. Was that sufficiently explained? – DisplayName Jul 21 '14 at 11:36

Yes. Usually only in the case of someone with hemophilia (no blood clotting) but it could theoretically occur with any serious uncontrolled nosebleed. Since blood in the stomach tends to cause vomiting, you could also lead to a scenario where someone who was uncomfortable with blood would pass out due to being scared of the blood and then aspirate (puke and then breath in) and end up dying in that way.

Hasn't happened to me though.

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This answer would be greatly improved if it was accompanied by references (or any case studies perhaps?). – Bez Jul 21 '14 at 16:46
@DevashishDas This is Biology beta, not StackOverflow. – J. Musser Jul 22 '14 at 0:26
Welcome to Biology Beta @Nathan!!! – Devashish Das Jul 22 '14 at 4:44

Yes it can but it is very rare.

Most often when you get a nosebleed it is either a vein or capillary that ruptures. However in some cases it is arterial bleeding which is always an emergency.

I have honestly noticed when I have nosebleeds often each one is worse than the previous with some having a lot of bleeding but still no gushing from an artery.

Arterial rupture in the nose and hemophilia are the 2 most common blood related causes of death from a nosebleed.

Another possibility is that it took too long for the broken nose to be treated and the cartilage ruptured an artery during the fracture. However this is much rarer than arterial rupture that is not related to fractures.

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