Increased conduit vessel stiffness results in increased characteristic impedance of the aorta and decreased arterial compliance, which cause an increase in systolic blood pressure (SBP) and pulse pressure as well as a decrease in diastolic blood pressure (DBP).
Local trauma is the most common cause, followed by facial trauma, foreign bodies, nasal or sinus infections, and prolonged inhalation of dry air. Children usually present with epistaxis due to local irritation or recent upper respiratory infection (URI).
Her personal history revelaed no pathology except for occasional epistaxis. Characteristic features include telangiectasias of the skin and oral and nasal mucosa, epistaxis, and arteriovenous malformations (AVMs) of the lungs, liver, brain, and gastrointestinal tract that can lead to hemorrhage and stroke (7-9).