Recurrent posterior reversible encephalopathy syndrome with cerebellar involvement leading to acute hydrocephalus.

•PRES causes a symmetric reversible vasogenic edema in any brain region.•PRES is the result of vascular auto-regulation failure and endothelial dysfunction.•Aggressive supportive therapy in PRES results in full recovery.•PRES can be complicated by hydrocephalus due to fourth ventricle compression.•PRES reoccurrence is possible if the underlying causes are still present.