CHIEF COMPLAINT: 

PRESENT ILLNESS: Open fracture of left frontal
sinus, anterior table.  Open nasal fracture.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Open fracture of base of skull with other and unspecified intracranial hemorrhage, with brief [less than one hour] loss of consciousness,Open fracture of nasal bones,Struck accidentally by falling object,Pure hypercholesterolemia,Unspecified essential hypertension
Opn skl base fx-brf coma,Nasal bone fx-open,Struck by falling object,Pure hypercholesterolem,Hypertension NOS
Admission Date:  [**2111-8-1**]     Discharge Date:  [**2111-8-6**]

Date of Birth:   [**2056-8-1**]     Sex:  M

Service:

HISTORY OF PRESENT ILLNESS:  Open fracture of left frontal
sinus, anterior table.  Open nasal fracture.

PHYSICAL EXAMINATION:  General:  Alert, oriented,
appropriate.  Cardiovascular:  Regular, rate, and rhythm.
Respiratory:  Clear to auscultation bilaterally.  Face:
Sutures intact and in place, supraorbitally and the nasal
bridge.  Minimal to moderate ecchymosis periorbitally.  Mild
tenderness to palpation.  Pupils are equal, round, and
reactive to light.  Extraocular movements are intact.

LABORATORIES:  On [**2111-8-5**], white blood cell count 9.7,
H&H 14.3/42.7, platelets 221.  Sodium 141, potassium 4.2,
chloride 103, bicarbonate 25, glucose 106.

SUMMARY OF HOSPITAL COURSE:  The patient is a 55-year-old
gentleman admitted through the Emergency Department following
being struck in the forehead by a tree branch while trimming
a tree on [**2111-8-1**].  Patient was taken to the operating
room for an open fracture of the left frontal sinus and nose
as indicated by CT scan.

The lacerations were closed, and the patient was admitted
originally under the Trauma Service and followed for a closed
head injury.  CT scan at time of admission showed an
approximately 4 cm markedly depressed fracture of the
anterior table of the left frontal sinus.  This extended to a
small minimal degree into the orbital rim on the left side.
There was no evidence of cerebrospinal fluid leak clinically.
The posterior table of the sinus was intact.  There was no
fracture in the neighborhood of the frontonasal duct.

Followup CT scan on [**8-2**] showed:
1. Stable appearance of multiple sulci of intraparenchymal
hemorrhage involving the right hemisphere.
2. Stable appearance of parafalcine subdural hematoma.
3. Comminuted left frontal sinus and nasal fractures.

Patient also remained stable clinically.  On [**2111-8-5**],
the patient was taken to the operating room by the Plastics
Service for reduction and fixation of the anterior table
fragment and nasal fracture utilizing plates and screws.
Patient's postoperative course was unremarkable except for
one episode of confusion postoperatively, noted by RN during
morning rounds on day of discharge.

M.D. examined the patient, who was by then alert, oriented
x4, appropriate, and lucid.  The patient explained that he is
"always confused in the morning."  Vital signs remained
stable throughout.  Patient was deemed to be suitable for
discharge and discharged on [**2111-8-6**].

CONDITION ON DISCHARGE:  Stable.

DISCHARGE STATUS:  To home.

DISCHARGE DIAGNOSES:
1. Open reduction internal fixation of left frontal sinus
fracture.
2. Open reduction internal fixation of nasal fracture.

DISCHARGE MEDICATIONS:
1. Clindamycin 450 mg po qid.
2. Percocet 1-2 tablets po q4-6h as needed for pain.
3. Colace 100 mg [**Hospital1 **].

FOLLOW-UP PLANS:  In Plastic Clinic on [**2111-8-11**].




                          [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 2647**], M.D.  [**MD Number(1) 2648**]

Dictated By:[**Last Name (NamePattern1) 21646**]

MEDQUIST36

D:  [**2111-8-18**]  14:29
T:  [**2111-8-21**]  12:42
JOB#:  [**Job Number 48471**]
{'Open fracture of base of skull with other and unspecified intracranial hemorrhage, with brief [less than one hour] loss of consciousness,Open fracture of nasal bones,Struck accidentally by falling object,Pure hypercholesterolemia,Unspecified essential hypertension'}


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: Open fracture of left frontal
sinus, anterior table.  Open nasal fracture.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Open fracture of base of skull with other and unspecified intracranial hemorrhage, with brief [less than one hour] loss of consciousness,Open fracture of nasal bones,Struck accidentally by falling object,Pure hypercholesterolemia,Unspecified essential hypertension'}
