Blood Transfusion-Triggered Posterior Reversible Encephalopathy Syndrome

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a rare neurological condition occurring due to the inability of the brain circulation to autoregulate in response to acute blood pressure changes. It presents with a spectrum of clinical features, which include seizures and encephalopathy. Radiological features observed are consistent with vasogenic edema, especially in the parieto-occipital region. We report a case where a patient presented with seizures following a rapid blood transfusion. The patient was diagnosed with transfusion-related PRES depending on the clinical features and MRI findings and the exclusion of other common etiologies. Abrupt cerebral hyperperfusion exceeding the capacity of autoregulation of the cerebral circulation results in vasogenic edema found in PRES. We suggest slow blood transfusion in patients with chronic anemia to prevent PRES development.