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Timely diagnosis and management of a retrorectal mass is essential for effective treatment and to prevent subsequent complications.A 62-year-old man with a past medical history of uncontrolled hypertension, tobacco abuse, and type 2 diabetes mellitus (DM) presented to the emergency department due to worsening confusion over the last 24 hours as reported by a friend. A CT brain without contrast was obtained, which demonstrated a bilateral intracerebral hemorrhage (ICH). Spontaneous bilateral intracerebral hemorrhage is an e