Posterior Reversible Encephalopathy Syndrome (PRES) following blood transfusion in a polytrauma victim, an atypical occurrence

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a neuroradiological syndrome, clinically present by impaired consciousness, headache, visual disturbances, and seizures, and radiologically brain edema. Cases of PRES induced by blood transfusion are rarely documented. We report this case to increase the awareness of treating physicians for the possible complications of rapid blood transfusion. A 29-year-old man presented with polytrauma and was in hemorrhagic shock. He was transfused with multiple transfusions. Later, he was found to have quadriplegia with minimal movement of fingers in the left hand. His computed tomography showed cerebral edema in multiple cerebral regions. We propose that the etiology in this case is that rapid blood transfusion induced acute rise in hemoglobin which led to PRES. The influences of blood transfusion on blood flow, blood viscosity, and endothelial dysfunction lead to blood–brain barrier dysfunction, which can result in PRES.