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This case report is about an 81-year-old male patient that was brought into the emergency room. Paramedics and an emergency doctor were alarmed because of unconsciousness of unclear origin. Additionally, ST-elevation were detected preclinically, raising the suspicion of an intercerebral hemorrhage; however, the clinical work-up revealed a different and unsuspected cause., (© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)