A 65-year-old woman with a history of bilateral lung transplantation on cyclosporine presented with progressive encephalopathy. Brain MRI 2 weeks after symptom onset demonstrated symmetric hyperintense fluid-attenuated inversion recovery signal with patchy areas o f restricted diffusion in the subcortical white matter of the parieto-occipital regions, consistent with posterior reversible encephalopathy syndrome (PRES) (Figure 1). Initial head CT showed new curvilinear cortical hyperdensities, and brain