CHIEF COMPLAINT: Basal Ganglia bleed

PRESENT ILLNESS: 34 yo F s/p epigastric hernia repair; post-operatively, the
patient went to the floor, and at 1340, was noted to have
difficulty talking, and garbled speech. She followed commands x
4, but had left sided flaccid hemiparesis. Her pupils were
equal and reactive, but a disconjugate gaze was noted. She
nodded to questions. The patient was intubated and sent by
Medivac to [**Hospital1 18**] for further treatment. She received Mannitol
and panvecuronium (10 mg) in flight. On arrival at [**Hospital1 18**], she
was immediately evaluated and noted to have b/l 6 mm dilated and

MEDICAL HISTORY: migraine, PUD, hypothyroidism, Cholecystectomy

MEDICATION ON ADMISSION: Vicodin
- potassium
- Celexa
- Inderal
- Protonix
- effervescent granule

ALLERGIES: No Drug Allergy Information on File

PHYSICAL EXAM: O: T: afebrile BP: 121/38 HR:109 O2Sats 97 on vent
Gen: intubated
HEENT: Pupils: 6 mm b/l unreactive.
Neuro:
Mental status: Intubated, and does not react to voices, noxious
stimuli

FAMILY HISTORY: Non contributory

SOCIAL HISTORY: lives with husband, no etoh, drug, cig abuse
Iatrogenic cerebrovascular infarction or hemorrhage,Intracerebral hemorrhage,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Migraine, unspecified, without mention of intractable migraine without mention of status migrainosus,Unspecified acquired hypothyroidism
Iatrogen CV infarc/hmrhg,Intracerebral hemorrhage,Abn react-surg proc NEC,Migrne unsp wo ntrc mgrn,Hypothyroidism NOS
Admission Date:  [**2160-8-26**]              Discharge Date:   [**2160-8-27**]

Date of Birth:  [**2127-1-30**]             Sex:   F

Service: NEUROSURGERY

Allergies:
No Drug Allergy Information on File

Attending:[**First Name3 (LF) 1271**]
Chief Complaint:
Basal Ganglia bleed

Major Surgical or Invasive Procedure:
None

History of Present Illness:
34 yo F s/p epigastric hernia repair; post-operatively, the
patient went to the floor, and at 1340, was noted to have
difficulty talking, and garbled speech. She followed commands x
4, but had left sided flaccid hemiparesis. Her pupils were
equal and reactive, but a disconjugate gaze was noted. She
nodded to questions. The patient was intubated and sent by
Medivac to [**Hospital1 18**] for further treatment. She received Mannitol
and panvecuronium (10 mg) in flight. On arrival at [**Hospital1 18**], she
was immediately evaluated and noted to have b/l 6 mm dilated and

nonreactive pupils. She was immediately taken to CT for CT
head/CTA for evaluation. A large right sided bleed was noted
with b/l IVH, herniation and mass effect. No aneurysms or AVMs
were noted.


Past Medical History:
migraine, PUD, hypothyroidism, Cholecystectomy

Social History:
lives with husband, no etoh, drug, cig abuse

Family History:
Non contributory

Physical Exam:
O: T: afebrile BP: 121/38 HR:109 O2Sats 97 on vent
Gen: intubated
HEENT: Pupils: 6 mm b/l unreactive.
Neuro:
Mental status: Intubated, and does not react to voices, noxious
stimuli

Cranial Nerves:
I: Not tested
II: Pupils equally round, 6mm unreactive bilaterally.
no gag, no cough, no corneals
4 weak twitches on the train of 4

Motor: Normal bulk bilaterally. weak withdrawal of bilateral LE,

L>R



Pertinent Results:
[**2160-8-27**] 12:47PM BLOOD Neuts-82.7* Bands-0 Lymphs-13.8*
Monos-2.7 Eos-0.2 Baso-0.6
[**2160-8-27**] 12:47PM BLOOD Hypochr-NORMAL Anisocy-NORMAL
Poiklo-NORMAL Macrocy-NORMAL Microcy-NORMAL Polychr-OCCASIONAL
[**2160-8-27**] 10:14PM BLOOD Plt Ct-299
[**2160-8-27**] 10:14PM BLOOD Fibrino-474*#
[**2160-8-27**] 10:14PM BLOOD Glucose-171* UreaN-5* Creat-0.5 Na-136
K-3.5 Cl-99 HCO3-25 AnGap-16
[**2160-8-27**] 10:14PM BLOOD ALT-15 AST-24 CK(CPK)-190* AlkPhos-69
Amylase-268* TotBili-0.7
[**2160-8-27**] 10:14PM BLOOD Lipase-15
[**2160-8-27**] 10:14PM BLOOD CK-MB-30* MB Indx-15.8* cTropnT-0.27*
[**2160-8-27**] 11:41PM BLOOD Type-ART pO2-393* pCO2-37 pH-7.42
calTCO2-25 Base XS-0
[**2160-8-27**] 11:41PM BLOOD O2 Sat-99

Brief Hospital Course:
A unfortunate 33 yo female with a large right sided bleed,
herniation, mass effect, and b/l IVH, morbid exam however she
hypothermic on exam she was admitted to the ICU for close
monitoring. Dr [**Last Name (STitle) 739**] spoke with the family regarding the
poor prognosis.  Neurology was consulted and saw the patient on
the second hospital day the patient was had a full brain death
by Neurology and Dr [**Last Name (STitle) **] and the exam
exam confirms lack of brainstem reflexes, in keeping with the
diagnosis of brain death. Family was notified notified of brain
death and social work is worked with family to help through this
difficult time. She passed away on [**8-27**].


Medications on Admission:
Vicodin
- potassium
- Celexa
- Inderal
- Protonix
- effervescent granule


Discharge Medications:
None

Discharge Disposition:
Expired

Discharge Diagnosis:
IPH

Discharge Condition:
Deceased

Discharge Instructions:
None

Followup Instructions:
None

                             [**Name6 (MD) 742**] [**Name8 (MD) **] MD [**MD Number(2) 1273**]

Completed by:[**2161-6-4**]
{'Iatrogenic cerebrovascular infarction or hemorrhage,Intracerebral hemorrhage,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Migraine, unspecified, without mention of intractable migraine without mention of status migrainosus,Unspecified acquired hypothyroidism'}


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: Basal Ganglia bleed

PRESENT ILLNESS: 34 yo F s/p epigastric hernia repair; post-operatively, the
patient went to the floor, and at 1340, was noted to have
difficulty talking, and garbled speech. She followed commands x
4, but had left sided flaccid hemiparesis. Her pupils were
equal and reactive, but a disconjugate gaze was noted. She
nodded to questions. The patient was intubated and sent by
Medivac to [**Hospital1 18**] for further treatment. She received Mannitol
and panvecuronium (10 mg) in flight. On arrival at [**Hospital1 18**], she
was immediately evaluated and noted to have b/l 6 mm dilated and

MEDICAL HISTORY: migraine, PUD, hypothyroidism, Cholecystectomy

MEDICATION ON ADMISSION: Vicodin
- potassium
- Celexa
- Inderal
- Protonix
- effervescent granule

ALLERGIES: No Drug Allergy Information on File

PHYSICAL EXAM: O: T: afebrile BP: 121/38 HR:109 O2Sats 97 on vent
Gen: intubated
HEENT: Pupils: 6 mm b/l unreactive.
Neuro:
Mental status: Intubated, and does not react to voices, noxious
stimuli

FAMILY HISTORY: Non contributory

SOCIAL HISTORY: lives with husband, no etoh, drug, cig abuse 

### Response:
{'Iatrogenic cerebrovascular infarction or hemorrhage,Intracerebral hemorrhage,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Migraine, unspecified, without mention of intractable migraine without mention of status migrainosus,Unspecified acquired hypothyroidism'}
