2026 American Academy of Neurology Abstract Website

Hossam Tharwat Ali¹, Abdullah Obadi², Yazan Nouh², Mohannad Abd-Alhadi², Abdulsalam Arebi², Khader Abutawahina², Ismail Habib², Bahy El-din Saied¹, Abdelrahman Nageh Ali Hafez¹, Eman Shazly³
¹Qena Faculty of Medicine, South Valley University, Qena, Egypt; Research Working Groups, Research Yard for Research and Academic Services, Qena, Egypt, ²Near East University, Cyprus., ³Resident Physician, Chest Department, Qena University Hospitals, Qena, Egypt; Research Working Groups, Research Yard for Research and Academic Services, Qena, Egypt

Objective:

This study aims to review cases of posterior reversible encephalopathy syndrome (PRES) and/or reversible cerebral vasoconstriction syndrome (RCVS) that occur following blood transfusion.

Background:

PRES and RCVS are two distinctly underrecognized entities that can show similar clinical and imaging characteristics and risk factors and may be a part of a spectrum of vascular dysregulation. There have been multiple reports of PRES/RCVS following blood transfusion that should be reviewed for relevant conclusions.

Design/Methods:

We conducted a systematic review of PubMed, Scopus, and Web of Science databases for detailed reports of blood transfusion-induced PRES/RCVS that were published until April 2025. Two authors independently screened the results, and a third author resolved the conflicts. We extracted data on demographics, transfusion details (type, volume, and duration), clinical symptoms, imaging findings, and management details. Pooled analysis was performed.

Results:

A total of 41 patients from 33 reports were included with a mean (SD) age of 43.27 (14.53) years, a female majority (96.56%), and a mean (SD) baseline hemoglobin of 2.85 (1.23) g/dL. The majority (95.12%) received packed red blood cells. The mean (SD) total volume transfused was 2100 (2560) ml over a median (IQR) duration of 2.50 (1 to 4) days. The most common symptoms were headache (75.61%), seizure (73.17%), visual disturbance (31.71%), and cognitive impairment (29.27%). Most patients (65.85%) experienced symptoms within one week. The most common imaging findings were subcortical edema (46.34%), cortical infarcts (34.15%), subcortical infarcts (26.83%), and cortical edema (19.51%). Regarding the conclusive diagnosis, 21 cases (51.22%) had PRES, nine cases (21.95%) had RCVS, and 11 (26.83%) had overlapping syndrome. While management has been mainly supportive, use of antihypertensive and anticonvulsant agents has been reported in 15 cases (36.59%) for each.

Conclusions:

Our research reviews the reported cases of PRES/RCVS following blood transfusion and contributes to the current knowledge of such underrecognized conditions.