CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 56 year-old man
with a history of a recent stroke at the end of [**Month (only) **]
causing a left sided weakness due to a right frontal stroke.
He also has a history of an old thalamic stroke in [**2179**].  The
patient had also been on Coumadin secondary to hip fractures
and had been in his nursing home since discharge from the
hospital.  He was well last night and woke up this morning
and initially felt well and then began to call for help with
new onset left sided weakness.  When the staff arrived they
found him leaning to the right with slurred speech.  The
patient quickly became less alert and was sent immediately to
[**Hospital1 69**] via ambulance.  On
arrival initially he was able to indicate answers to yes or
no questions, but soon became completely unresponsive.

MEDICAL HISTORY: 1.  Right thalamic stroke in [**2179**].
2.  Right frontal stroke several weeks ago.
3.  Gunshot wound in [**2155**].
4.  Hip fracture [**9-2**].
5.  Hypertension.
6.  Hepatitis C.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Smokes a pack a day.  No alcohol or
intravenous drug use for years.  Lives in a group home.
Intracerebral hemorrhage,Acute respiratory failure,Acute hepatitis C without mention of hepatic coma,Cerebral edema,Long-term (current) use of anticoagulants,Unspecified essential hypertension,Tobacco use disorder,Other late effects of cerebrovascular disease,Other musculoskeletal symptoms referable to limbs
Intracerebral hemorrhage,Acute respiratry failure,Hpt C acute wo hpat coma,Cerebral edema,Long-term use anticoagul,Hypertension NOS,Tobacco use disorder,Late effect CV dis NEC,Muscskel sympt limb NEC
Admission Date:  [**2189-11-29**]       Discharge Date:  [**2189-11-29**]

Date of Birth:                    Sex:  M

Service:  NEURO ICU

HISTORY OF PRESENT ILLNESS:  The patient is a 56 year-old man
with a history of a recent stroke at the end of [**Month (only) **]
causing a left sided weakness due to a right frontal stroke.
He also has a history of an old thalamic stroke in [**2179**].  The
patient had also been on Coumadin secondary to hip fractures
and had been in his nursing home since discharge from the
hospital.  He was well last night and woke up this morning
and initially felt well and then began to call for help with
new onset left sided weakness.  When the staff arrived they
found him leaning to the right with slurred speech.  The
patient quickly became less alert and was sent immediately to
[**Hospital1 69**] via ambulance.  On
arrival initially he was able to indicate answers to yes or
no questions, but soon became completely unresponsive.

PAST MEDICAL HISTORY:
1.  Right thalamic stroke in [**2179**].
2.  Right frontal stroke several weeks ago.
3.  Gunshot wound in [**2155**].
4.  Hip fracture [**9-2**].
5.  Hypertension.
6.  Hepatitis C.

ALLERGIES:  No known drug allergies.

MEDICATIONS:
1.  Baclofen.
2.  Procardia.
3.  Elavil.
4.  Neurontin.
5.  Coumadin 5 mg q day.
6.  Percocet prn.

SOCIAL HISTORY:  Smokes a pack a day.  No alcohol or
intravenous drug use for years.  Lives in a group home.

PHYSICAL EXAMINATION ON ADMISSION:  He was afebrile.  His
blood pressure was 200s/100s with a pulse in the 130s.
Generally he was a diaphoretic unresponsive to voice.  He was
quickly intubated.  He did not open his eyes to command or to
sternal rub.  His pupils were 5 mm bilaterally and
nonreactive with no response to visual threat.  He had no
response to oculocephalic or ocular vestibular maneuvers.  He
had no gag.  He had no corneal reflexes.  His motor
examination although initially he withdrew his left arm from
pain and had extensor posturing from the right arm, quickly
progressed to no movement to any stimulation in any of his
lower extremities with no spontaneous movements.  His
reflexes were trace to absent throughout.

His head CT showed a large left basal ganglia hemorrhage with
blood throughout the ventricular system and with significant
shift and mass effect as well as some edema.

HOSPITAL COURSE:  The patient was admitted to the
Neurological Intensive Care Unit with a large left basal
ganglia bleed.  He received fresh frozen platelets to reverse
his INR of 3, although no factor 9 complex was available from
the pharmacy on admission.  Neurosurgery was consulted, but
was unable to place a drain with his INR at 3.  His blood
pressure was controlled with Nipride and Labetalol drips.
His family came into the hospital and another head CT was
performed with increase in bleeding as well as edema and
continued shift.  His examination remained without brain stem
reflexes and with no evidence of cortical function.  After
prolonged discussion with his family members the family
decided to make the patient CMO and to extubate him.  He was
extubated around 7:00 on the [**8-30**] and the patient
expired soon after.  The patient was declared at 9:00 p.m.
He had no carotid pulse, no respirations and no heart beat.
The cause of death immediately was respiratory failure.  The
other main cause of death was intracranial hemorrhage.  The
family was not interested in an autopsy.  They were informed
of his death.

DISCHARGE DIAGNOSIS:
Large left basal ganglia hemorrhage with shift in edema.

DISCHARGE STATUS:  Expired.




            DR [**Last Name (STitle) **] [**Name (STitle) 4267**] 13.282



Dictated By:[**Last Name (NamePattern1) 1203**]
MEDQUIST36

D:  [**2189-11-29**]  10:22
T:  [**2189-11-30**]  07:12
JOB#:  [**Job Number 93316**]
{'Intracerebral hemorrhage,Acute respiratory failure,Acute hepatitis C without mention of hepatic coma,Cerebral edema,Long-term (current) use of anticoagulants,Unspecified essential hypertension,Tobacco use disorder,Other late effects of cerebrovascular disease,Other musculoskeletal symptoms referable to limbs'}


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 56 year-old man
with a history of a recent stroke at the end of [**Month (only) **]
causing a left sided weakness due to a right frontal stroke.
He also has a history of an old thalamic stroke in [**2179**].  The
patient had also been on Coumadin secondary to hip fractures
and had been in his nursing home since discharge from the
hospital.  He was well last night and woke up this morning
and initially felt well and then began to call for help with
new onset left sided weakness.  When the staff arrived they
found him leaning to the right with slurred speech.  The
patient quickly became less alert and was sent immediately to
[**Hospital1 69**] via ambulance.  On
arrival initially he was able to indicate answers to yes or
no questions, but soon became completely unresponsive.

MEDICAL HISTORY: 1.  Right thalamic stroke in [**2179**].
2.  Right frontal stroke several weeks ago.
3.  Gunshot wound in [**2155**].
4.  Hip fracture [**9-2**].
5.  Hypertension.
6.  Hepatitis C.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Smokes a pack a day.  No alcohol or
intravenous drug use for years.  Lives in a group home. 

### Response:
{'Intracerebral hemorrhage,Acute respiratory failure,Acute hepatitis C without mention of hepatic coma,Cerebral edema,Long-term (current) use of anticoagulants,Unspecified essential hypertension,Tobacco use disorder,Other late effects of cerebrovascular disease,Other musculoskeletal symptoms referable to limbs'}
