CHIEF COMPLAINT: Intracerebral bleed.

PRESENT ILLNESS: There were no family present to
give a history so most of the history was obtained from
notes.  The patient took a nap at 04:00 p.m. and was awakened
for dinner around 06:00 p.m.  He awoke, talking gibberish and
vomiting twice with inability to walk.  His wife called
Emergency Medical Services.  In the Emergency Department he
was intubated and wife opted for medical management only.

MEDICAL HISTORY: 1.  Microvascular periventricular infarction.
2.  Hypertension.
3.  Hypercholesterolemia.
4.  Seizure.
5.  Question of a right frontal venous angioma.
6.  Question of old left posterior parietal stroke.

MEDICATION ON ADMISSION: 

ALLERGIES: To aspirin which causes a rash.

PHYSICAL EXAM: 

FAMILY HISTORY: None could be obtained.

SOCIAL HISTORY: He is a Chinese man living with his wife.
[**Name (NI) **] has a 75 pack year smoking history but quit 30 years ago.
Intracerebral hemorrhage,Other convulsions,Unspecified essential hypertension,Pure hypercholesterolemia
Intracerebral hemorrhage,Convulsions NEC,Hypertension NOS,Pure hypercholesterolem
Admission Date:  [**2172-12-11**]     Discharge Date:  [**2172-12-13**]


Service:

CHIEF COMPLAINT:   Intracerebral bleed.

HISTORY OF PRESENT ILLNESS:   There were no family present to
give a history so most of the history was obtained from
notes.  The patient took a nap at 04:00 p.m. and was awakened
for dinner around 06:00 p.m.  He awoke, talking gibberish and
vomiting twice with inability to walk.  His wife called
Emergency Medical Services.  In the Emergency Department he
was intubated and wife opted for medical management only.

Of note, the patient had an episode of aphasia attributed to
a seizure in [**2171**].  MRI scan at that time revealed a left
parietal area that was positive for blood.  Neurology felt
that it could be possibly stroke with some hemorrhagic
conversion and recommended Plavix.

Neurosurgery commented that there was a question of
arteriovenous malformation that may need to be followed with
scans.  The patient was not discharged on any anti-epileptic
medications.  It is now known if he has had any other seizure
or neurological symptoms since [**2171**].

PAST MEDICAL HISTORY:
1.  Microvascular periventricular infarction.
2.  Hypertension.
3.  Hypercholesterolemia.
4.  Seizure.
5.  Question of a right frontal venous angioma.
6.  Question of old left posterior parietal stroke.

FAMILY HISTORY:   None could be obtained.

SOCIAL HISTORY:   He is a Chinese man living with his wife.
[**Name (NI) **] has a 75 pack year smoking history but quit 30 years ago.

MEDICATIONS AT HOME:
1.  Enalapril.
2.  Atenolol.
3.  Plavix.
4.  Zocor.
5.  Levoxyl.
6.  Azmacort.
7.  Albuterol.

MEDICATIONS AFTER ADMISSION:
1.  Regular insulin sliding scale.
2.  Hydralazine.
3.  Dilantin 100 mg three times a day.
4.  Levofloxacin.
5.  Flagyl.
6.  Mannitol.
7.  Famotidine.

ALLERGIES:   To aspirin which causes a rash.

PHYSICAL EXAMINATION:   Temperature 99.6 F.; pulse 61; blood
pressure 141/49; 100% on ventilation with pressure support of
5, PEEP of 5 and FIO2 of 0.4.  Respiratory rate 15.
Generally, this is a male who is intubated.  Neck with no
carotid bruits noted.  Cardiovascular is regular rate and
rhythm with no murmurs, rubs or gallops noted.  Lungs are
clear to auscultation anteriorly.

Neurological examination:  The patient is intubated and
nonverbal.  He physically moves with painful stimuli.  On
cranial nerve examination he has surgical pupils bilaterally.
 They are not reactive.  His eyes are midline.  There is no
corneal reflex on the right.  He has intact doll's eyes.
There is no gag reflexes.  On motor and sensory examination,
he withdraws from pain on the left arm and leg.  He postures
and moves with pain to the right arm and leg.  There is
decreased tone on the right arm and leg.  On reflexes, he is
two out of four throughout.  His toes were upgoing
bilaterally.

LABORATORY:  His labs and radiology are as follows:  White
blood cell count 16.4, hematocrit 33.2, platelets 287.
Sodium 135, potassium 3.7, chloride 98, bicarbonate 25, BUN
14, creatinine 1.0, glucose 195, calcium 8.5, phosphorus 3.1,
magnesium 1.7.  CK 96, troponin less than 0.01.  Dilantin
8.2.  Lactate 5.7.  Serum osmolality was 302.

A Non-contrast head CT scan showed a left posterior parietal
hemorrhage.

HOSPITAL COURSE:   Initially, the patient's blood pressure
was controlled between 130 and 160s.  Mannitol was given for
control of cerebral edema.  He was also continued on Dilantin
for seizure prophylaxis.

The patient was given Levofloxacin and Flagyl for aspiration
pneumonia.

The patient deteriorated both on the medical and neurologic
examinations during his short hospital course.  The family
decided to withdraw all care except to keep the intubation
until another family member arrived.

Unfortunately, he passed away due to apnea and bradycardia on
[**2172-12-13**].

                          [**First Name8 (NamePattern2) **] [**First Name8 (NamePattern2) 5930**] [**Last Name (NamePattern1) **], M.D.  [**MD Number(1) 6125**]

Dictated By:[**Last Name (NamePattern1) 4270**]

MEDQUIST36

D:  [**2172-12-18**]  14:42
T:  [**2172-12-19**]  22:00
JOB#:  [**Job Number 109137**]
{'Intracerebral hemorrhage,Other convulsions,Unspecified essential hypertension,Pure hypercholesterolemia'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: Intracerebral bleed.

PRESENT ILLNESS: There were no family present to
give a history so most of the history was obtained from
notes.  The patient took a nap at 04:00 p.m. and was awakened
for dinner around 06:00 p.m.  He awoke, talking gibberish and
vomiting twice with inability to walk.  His wife called
Emergency Medical Services.  In the Emergency Department he
was intubated and wife opted for medical management only.

MEDICAL HISTORY: 1.  Microvascular periventricular infarction.
2.  Hypertension.
3.  Hypercholesterolemia.
4.  Seizure.
5.  Question of a right frontal venous angioma.
6.  Question of old left posterior parietal stroke.

MEDICATION ON ADMISSION: 

ALLERGIES: To aspirin which causes a rash.

PHYSICAL EXAM: 

FAMILY HISTORY: None could be obtained.

SOCIAL HISTORY: He is a Chinese man living with his wife.
[**Name (NI) **] has a 75 pack year smoking history but quit 30 years ago. 

### Response:
{'Intracerebral hemorrhage,Other convulsions,Unspecified essential hypertension,Pure hypercholesterolemia'}
