CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 38-year-old
previously healthy woman who presented to [**Hospital3 15175**] with complaints of severe headache.

MEDICAL HISTORY: Past medical history of a cesarean
section.

MEDICATION ON ADMISSION: 

ALLERGIES: Allergy to PENICILLIN.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: She is married with children.
Subarachnoid hemorrhage,Bacteremia
Subarachnoid hemorrhage,Bacteremia
Admission Date:  [**2194-11-9**]       Discharge Date:  [**2194-12-5**]

Date of Birth:   [**2156-6-6**]       Sex:  F

Service:

HISTORY OF PRESENT ILLNESS:  The patient is a 38-year-old
previously healthy woman who presented to [**Hospital3 15175**] with complaints of severe headache.

The patient had complained of the worst headache of her life,
called Emergency Medical Service, and when they arrived was
found unresponsive, seizing, and vomiting.  She had a head
computed tomography which showed a large subarachnoid
hemorrhage with blood in the basal cistern.

She was transferred to [**Hospital1 69**]
for further treatment.

PAST MEDICAL HISTORY:  Past medical history of a cesarean
section.

ALLERGIES:  Allergy to PENICILLIN.

SOCIAL HISTORY:  She is married with children.

PHYSICAL EXAMINATION ON PRESENTATION:   On physical
examination, her blood pressure was 132/64, heart rate was
133.  Her neck was supple.  Cardiovascular examination
revealed she was tachycardic.  No murmurs, rubs, or gallops.
The abdomen was soft, nontender, and nondistended.
Extremities revealed no clubbing, cyanosis, or edema.
Neurologically, she was sedated, minimally opened her eyes,
not following commands.  Her face was symmetric.  Eyes were
conjugate.  Pupils were 4 mm, down to 2 mm, and briskly
reactive.  She was opening her eyes, moving arms and legs.
Intermittently attentive.

RADIOLOGY/IMAGING:  A head computed tomography at the outside
hospital showed blood in the basal cistern and possible small
right subdural hematoma.

HOSPITAL COURSE:   On arrival, she had a left frontal
ventroscopy drain placed and was taken emergently to
arteriogram where she had a posterior communicating artery
aneurysm coiled without complications.

Postoperatively, she was monitored in the Surgical Intensive
Care Unit.  Her pupils were 1.5 mm and trace reaction,
symmetric.  The face was symmetric.  She would open her eyes.
She was not following commands.  Her toes were downgoing.

Her laboratories revealed her white blood cell count was 18.1
and hematocrit was 31.2.  INR was 1.4.  PTT was 94.3.  Sodium
was 138, potassium was 4.1, chloride was 108, bicarbonate was
18, blood urea nitrogen was 7, creatinine was 0.5, and blood
glucose was 137.

She remained in the Surgical Intensive Care Unit.  On
[**2194-11-11**], the patient extubated herself.  Her lungs
were clear throughout.  Her abdomen was soft.

On [**2194-11-13**], her intracranial pressure was 11 to 16
throughout the night.  Her drain put out 317 cc.  She was
awake and conversant and opening eyes.  She moved all
extremities spontaneously.  Pupils were 3 mm, down to 2 mm,
and brisk.  She had a question of a right upper extremity
drift without pronation.

She had transcranial Doppler studies done on a daily basis
which showed no evidence of vasospasm initially.  She was
started on triple-H therapy to keep prevent vasospasm on
[**2194-11-13**] with intravenous fluids going at 150.  She
was started on Neo-Synephrine to keep her blood pressure 150
to 170 and her central venous pressure 8 to 10.

She had a repeat transcranial Doppler studies on [**2194-11-18**] which showed an increased velocity in the left side.

On [**2194-11-24**], the patient was taken to the Angiogram
Suite to evaluate for vasospasm.  She was given papaverine
for a small amount of spasm.  She was lethargic.  Not
answering questions but was following some commands.  When
she returned from angiogram, as the day progressed, she
improved vastly.  She was awake, alert and oriented times
three.  She was moving all extremities with good strength.
No drift.

The patient's Neo-Synephrine drip was discontinued on
[**2194-11-29**].  She was able to keep her blood pressure
above 120.  She was neurologically intact.

On [**11-30**], the ventroscopy drain was raised to 20 cm
above the tragus, and she tolerated that without any further
episodes of lethargy.  On [**2194-12-2**], the ventroscopy
drain was removed.

DISCHARGE DISPOSITION:  On [**2194-12-3**], the patient was
transferred to the regular floor.  She was seen by Physical
Therapy and Occupational Therapy and found to be safe for
discharge to home.

MEDICATIONS ON DISCHARGE:  She was to be discharged home on
Dilantin 75 mg p.o. t.i.d.; with a Dilantin level on the day
of discharge of 10.3.

CONDITION AT DISCHARGE:  Her neurologic status was stable.
The patient was stable for discharge.

DISCHARGE FOLLOWUP:   The patient was to follow up with Dr.
[**Last Name (STitle) 1132**] in two to three weeks without repeat scans.





                            [**Name6 (MD) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 1133**]

Dictated By:[**Last Name (NamePattern1) 344**]
MEDQUIST36

D:  [**2194-12-5**]  12:03
T:  [**2194-12-5**]  13:07
JOB#:  [**Job Number 45188**]
{'Subarachnoid hemorrhage,Bacteremia'}


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: 

PRESENT ILLNESS: The patient is a 38-year-old
previously healthy woman who presented to [**Hospital3 15175**] with complaints of severe headache.

MEDICAL HISTORY: Past medical history of a cesarean
section.

MEDICATION ON ADMISSION: 

ALLERGIES: Allergy to PENICILLIN.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: She is married with children. 

### Response:
{'Subarachnoid hemorrhage,Bacteremia'}
