We present the case of a young man who was previously well, but became unconscious while watching a football match. He was initially found to be hypertensive, with clinical and echocardiographic evidence of cardiac failure. He also had a fixed and dilated pupil. CT brain scanning was normal and it was only after a MR brain scan was performed that the diagnosis of posterior reversible encephalopathy syndrome was raised. Despite the name of the condition implying that neurological deficits are reversible, this patient had a prolonged period of disability requiring long-term rehabilitation.
