Can brain tumors cause nose bleeds?

In this article we are going to answer the question ‘’Can brain tumors cause nose bleeds?’’ We will explain the main causes of nosebleeds and the relationship they have with brain tumors.

Can brain tumors cause nose bleeds?

Yes, brain tumors can cause nose bleeds, but it is highly unlikely. Nosebleeds are more likely to be due to other causes.

All that foreign tissue that arises within the cavity of the skull is called a brain tumor, although these also sometimes appear in the meninges, nerves and in the skull itself. For obvious reasons, they are one of the main health problems that affect the nervous system, given their potential severity.

Brain tumors are a rare type of tumor in adults. There are different types, some of them are benign and others are malignant (cancerous). The majority of malignant tumors are due to the spread (metastasis) of cancer located elsewhere in the body, with malignant tumors originating from the brain itself being more rare. Brain tumors can be classified into:

Brain metastases. They are the most common cause of malignant brain tumors in adults. Metastases are due to the spread of a tumor located in another area of ​​the body, usually lung cancer, breast cancer, or melanoma.

They usually appear in patients who know they have cancer in a certain place, although, sometimes, brain metastases are the first manifestation of the presence of a cancer that they did not know they had.

Primary intracranial tumors

Brain tumors can come from another part of the body. Breast cancer, lung cancer, malignant (skin) melanoma, etc. they can spread to the brain. This process of expansion is what is called metastasis: the spread to distant tissues, which usually takes place through the blood or lymphatic vessels.

Primary brain tumors are those that originate in the brain, that is, they do not have their origin in other parts of the body.

The incidence of intracranial tumors is around 8 cases per 100,000 inhabitants. They usually appear during childhood and also from the age of forty or fifty.

The type of tumor and its location are determined by age; infratentorial astrocytomas and midline tumors such as medulloblastoma and pinealoma predominate in childhood and adolescence; in adulthood, anaplastic astrocytomas and glioblastomas (which are the most diagnosed primary intracranial tumors, although the most frequent in autopsy series is meningioma).

The origin of primary intracranial tumors is unknown. Some hereditary diseases have a high incidence of intracranial tumors, which suggests the existence of predisposing genetic factors.

The cause of some cases of brain tumor (schwannoma, meningioma, sarcoma and glioma) may be that the patient has been exposed to chemotherapy and / or cranial radiation therapy. Viral infections only seem to be relevant in the cases of Epstein Barr virus and primary brain lymphoma, especially when this tumor is associated with AIDS.

Astrocytoma

It is another type of glioma. Gliomas are tumors that grow from the tissues that support and surround nerve cells.

Astrocytoma comprises a group of tumors with very different forms of biological behavior. There are pilocytic, diffuse, and anaplastic astrocytomas.

The treatment of pilocytic astrocytoma is surgical. In diffuse low-grade astrocytomas, radiation therapy is recommended after surgery, especially if there are remains of the tumor. Treatment for anaplastics is the same as for glioblastomas.

Glioblastoma 

This tumor represents 20 percent of all intracranial tumors and belongs to the family of tumors called gliomas (in fact, half of the gliomas are glioblastomas). Gliomas are tumors that grow from the tissues that support and surround nerve cells.

It behaves with marked malignancy, rapidly invading brain tissue and is often already large at the time of diagnosis, occupying more than one lobe of the brain or spreading to the opposite hemisphere through the corpus callosum (the corpus callosum is a conglomeration of fibers white nerve connecting these two hemispheres).

The clinical picture initially consists of general manifestations such as headache, vomiting, mental disorders and seizures (epileptic) followed after a few weeks by a focal lobar syndrome or a corpus callosum syndrome. Given that it is a highly vascular tumor, on occasions the debut can be ictal (with death of brain tissue) due to intratumoral hemorrhage. 

Ependymoma

It is a tumor derived from ependymal cells. Studying the tissue, it appears “benign”, but a minority of tumors show anaplastic changes. The clinical picture depends on the location.

Fourth ventricular ependymomas cause hydrocephalus (abnormal dilation of the cerebral ventricles due to excess cerebrospinal fluid in the brain) and a general intracranial hypertension syndrome.

Meningioma

It is a benign tumor originating from arachnoid cells.

It is a well-defined, rounded or flattened tumor (plaque meningioma) and separated from the essential tissue of the brain by a capsule. It originates in the cells of the membrane that lines the brain.

Primary brain lymphoma

It represents 1-2 percent of all primary intracranial tumors but its incidence is increasing due to the association it has with states of acquired immunosuppression (AIDS, prolonged chemotherapy, transplants) or congenital (ataxia-telangiectasia, Wiskott-Aldrich syndrome) .

Most are B-cell lymphomas (tumors of the lymphatic tissue) with intermediate or high grade of malignancy.

They are located in any part of the brain, cerebellum and spinal cord and in 10 percent of cases they are found in more than one location.

Why does the nose bleed?

Nasal bleeding, or also called epistaxis, is a hemorrhage from the nose. There are two types of bleeding:

• Anterior nose bleed: It occurs in 90% of cases. It occurs when the blood vessels in the front of the nose break and bleed.
• Posterior nosebleed: It occurs in the deepest part of the nose. In this case, the blood flows down the back of the throat. This bleeding can range from drops, a trickle of blood or a heavy discharge and the consequences range from minor discomfort to bleeding that can be life-threatening.

Why does the nose usually bleed?

The most frequent causes are: 

• Nose picking
• Putting something inside your nose (foreign bodies)
• Allergic rhinitis or a cold, especially when accompanied by sneezing, coughing, and a lot of nose blowing
• Vascular lesions (septal varices)
• Dryness of the nasal mucosa due to dry environments
• Nasal trauma
• Deviations and malformations of the nasal septum
• Nasal infectious-inflammatory processes
• Use of blood-thinning medications

Likewise, there are other causes that respond to external factors of greater care and that are less common. Some of these are: 

• Leukemia
• Hemophilia
• Tumors in the nasal cavity
• Hormonal problems

Is it a serious problem?

It is a relatively frequent reason for consultation that, although it is not usually serious, can be annoying and worrying, especially if it is a pediatric patient. Most nosebleeds seem worse than they are.

That is, nosebleeds are quite bulky, somewhat annoying and sometimes can even scare, but they are not usually a major problem, becoming self-limited. In some cases they can even be recurrent.

However, you should seek medical attention if the nosebleed lasts more than 20 minutes or if it occurs after an injury. This may be a sign of a posterior nosebleed, which is somewhat more serious.

Injuries that can cause a nosebleed include a fall, a car accident, or a punch to the face. Nosebleeds that occur after an injury may indicate a broken nose, skull fracture, or internal bleeding.

What to do with a nosebleed?

Faced with an episode of epistaxis, the patient and the family member must remain calm, remembering that nosebleeds are usually self-limited and originate from the nasal passages themselves.

To do this, you must do the following:

• Do not lay down. Sit with your head forward. Don’t tilt it back, as it could cause blood to flow down your throat and into your airways.
• Pinch the soft part of your nose (just below the bony part of your nose) and breathe through your mouth. Help yourself by placing a towel so that it contains the blood. Do this for 10 minutes straight.
• You can insert cotton or gauze while applying pressure, or impregnate the cotton with hydrogen peroxide before inserting it into the nose to achieve a better hemostatic effect. Remember, DO NOT USE ALCOHOL.
• If you can’t stop the bleeding after pressing your nose for 10 minutes at a time, do it again for 10 more minutes. If the nose continues to bleed, you should go to the nearest health center for professional help.

So, can brain tumors cause nose bleeds?

Juvenile angiofibroma is more common among male adolescents. The tumor contains many blood vessels. It can grow slowly, spreading to the area around the brain and into the eye sockets.

Usually the tumor causes a stuffy nose or headache, often with nosebleeds, which can be very serious. Swelling of the face or bulging of one eye occurs. A mass may also protrude from the nose, or the nose may become disfigured. If the tumor grows slowly, symptoms are rare.

You or a family member should call a doctor or take you to an emergency department if:

• You are dizzy, weak or feel like you are going to pass out
• There is presence of sweating, paleness and palpitations
• Your nosebleed was very bad and you seem to be losing a lot of blood.
• The bleeding is not evidenced by the nose, but by the throat and is accompanied by vomiting of bloody content.
• You will have other symptoms, such as unusual bruising on the body.
• You have been bleeding for a long time after hurting yourself.
• Other parts of your body will bleed, such as your gums.
• Keeping the air humidifier in your home and avoiding picking your nose are good ways to help prevent nosebleeds.

FAQS: Can brain tumors cause nose bleeds?

Can brain tumors cause nosebleeds?

It is possible that this tumor begins in the olfactory nerve, which transmits smell-related signals from the nose to the brain. Olfactory neuroblastoma patients can suffer regular bleeding from the nose, lose their sense of smell and have trouble breathing through their nostrils.

What type of cancer causes nosebleeds?

For more severe disorders, such as leukaemia, nasal and sinus cancer, lymphoma, nasal polyps or tumors, repeated nosebleeds may be a sign.

Can a nosebleed be a sign of a brain bleed

The most frequent symptom of HHT is nosebleeds, but unexpected ischemic stroke, brain abscess, or bleeding into the brain (hemorrhagic stroke) or lungs may be triggered by AVMs in the lungs or brain, typically having no symptoms.

Can nosebleeds be a sign of a tumor?

Sinus infections and nosebleeds include symptoms of paranasal sinus and nasal cavity cancer.

Can a bloody nose be serious?

Normally, nosebleeds aren’t extreme. However, more severe health issues such as elevated blood pressure or a blood clotting condition can be suggested by regular or heavy nosebleeds and should be tested.

In this article we answered the question ‘’Can brain tumors cause nose bleeds?’’ We explained the main causes of nosebleeds and the relationship they have with brain tumors.

If you have any questions or comments please let us know!

References

DeAngelis, L. M. (2001). Brain tumors. New England journal of medicine, 344(2), 114-123.

Zülch, K. J. (2013). Brain tumors: their biology and pathology. Springer-Verlag.