CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 30-year-old
male with the past medical history of seizures and
oligodendroglioma status post resection in [**2133**], who presents
with a fall and seizure on the morning of admission.  The
patient was in his usual state of health until the morning
when he fell at work.  He does not recall a precipitating
event.  He fell backwards and struck his occiput.  He had
loss of consciousness at the scene.  The patient was brought
to the emergency department.  He received Dilantin times one
gram and Ativan and he stopped seizing.  CT in the emergency
department showed left sided occipital and temporal subdural
hematomas.  Hairline fracture was noted at the clivus.  The
patient reports no headache at this time.  His last seizure
was approximately one year ago and the seizures have been
well controlled with Tegretol.  He presents for evaluation
and treatment of the subdural hematoma.  The patient has
residual right hemiparesis from surgery.

MEDICAL HISTORY: 1.  Oligodendroglioma status post resection in [**2133**].
2.  Seizures.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient is allergic to ERYTHROMYCIN.

PHYSICAL EXAM: 

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: The patient works in college in
administration.
Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, unspecified state of consciousness,Other convulsions,Personal history of malignant neoplasm of brain,Fall from other slipping, tripping, or stumbling
Cl skl base fx/menin hem,Convulsions NEC,Hx of brain malignancy,Fall from slipping NEC
Admission Date:  [**2145-7-7**]       Discharge Date:  [**2145-7-9**]

Date of Birth:   [**2115-5-6**]       Sex:  M

Service:

HISTORY OF THE PRESENT ILLNESS:  The patient is a 30-year-old
male with the past medical history of seizures and
oligodendroglioma status post resection in [**2133**], who presents
with a fall and seizure on the morning of admission.  The
patient was in his usual state of health until the morning
when he fell at work.  He does not recall a precipitating
event.  He fell backwards and struck his occiput.  He had
loss of consciousness at the scene.  The patient was brought
to the emergency department.  He received Dilantin times one
gram and Ativan and he stopped seizing.  CT in the emergency
department showed left sided occipital and temporal subdural
hematomas.  Hairline fracture was noted at the clivus.  The
patient reports no headache at this time.  His last seizure
was approximately one year ago and the seizures have been
well controlled with Tegretol.  He presents for evaluation
and treatment of the subdural hematoma.  The patient has
residual right hemiparesis from surgery.

PAST MEDICAL HISTORY:
1.  Oligodendroglioma status post resection in [**2133**].
2.  Seizures.

MEDICATIONS:  Tegretol XR.

ALLERGIES:  The patient is allergic to ERYTHROMYCIN.

FAMILY HISTORY:  Noncontributory.

SOCIAL HISTORY:  The patient works in college in
administration.

PHYSICAL EXAMINATION:  Examination revealed the following:
VITAL SIGNS:  The patient is afebrile.  Blood pressure is
124/85, pulse 72, breathing 98% on room air.  GENERAL:  The
patient is a well-nourished, well developed young male lying
in the Emergency Department bed in no apparent distress.
HEENT:  Small laceration on occiput, not actively bleeding.
PULMONARY:  Clear to auscultation bilaterally;
CARDIOVASCULAR:  Regular rate and rhythm; normal S1 and S2,
no murmurs, rubs, or gallops.  ABDOMEN:  Soft, nontender,
nondistended, no rebound, guarding, no hepatosplenomegaly,
positive bowel sounds times four.  EXTREMITIES:  2+ pulses,
no edema.  BACK:  There is an 8 cm x 10 cm hematoma on the
right flank, no tenderness of the spine.  NEUROLOGICAL:  The
patient is awake, alert, and oriented time three.  Language
is fluent with good repetition.  Registration, coding, and
recall are intact.  Concentration and calculation are
accurate.  CRANIAL NERVES:  Visual acuity is normal.  Optic
disks are clear.  Visual fields:  Not tested.  Extraocular
muscles are intact.  Pupils:  6 to 4 bilaterally; symmetric
in light and dark.  Facial sensation possibly decreased to
gross touch on right.  Facial strength shows a small
elevation of the lower left half of the face.  Hearing is
intact to finger rub.  Palatal elevation is symmetrical.
Tongue is midline with symmetrical side-to-side movements.
Motor examination:  Left upper extremity is [**4-18**] throughout.
Right upper extremity revealed biceps 4+, triceps 4, reflexes
4-, wrist extensors 4-, finger flexors 4, finger extensors
4-, iliopsoas 4-, dorsiflexors 4, plantarflexor 4, [**Last Name (un) 938**] 4.
Normal bulk and tone on left.  Decreased bulk, decreased tone
on right, no fasciculations.  Reflexes on the right:  The
patient is diffusely 3, 4 on the left biceps 1+, brachialis
2, patella 2, Achilles 2.  Sensation is intact to pain, gross
touch, and proprioception, coordination finger-to-nose, rapid
alternating movements intact on the left.  The patient could
not be evaluated on the right secondary to weakness.

LABORATORY DATA:  Labs on admission revealed the following:
White count 7.6, hematocrit 46, platelet count 304,000.
Sodium 143, potassium 4.1, chloride 101, bicarbonate 22, BUN
14, creatinine 1.0, glucose 120, calcium 9.4, magnesium 2,
phosphate 3, PT 13.5, INR 1.3, PTT 29.5.  Head CT showed
small left occipital and temporal subdural hematomas.
Hairline fracture of the occipital bone left of the midline,
no shift of midline structures, no hydrocephalus.  Cervical
spine showed no evidence for fracture.

HOSPITAL COURSE:  The patient was initially admitted to the
Trauma Intensive Care Unit for observation.  He had a repeat
MRI, which did not show any expansion of his hematoma.  He
also had no evidence of recurrence of his oligodendroglioma.
The patient remains stable.  He was not continued on Dilantin
as there was a report of a potential drug fever in the past.
The patient was discharged home on [**2145-7-9**].  He was
discharged in stable condition.

DISCHARGE MEDICATIONS:  Tegretol 800 mg PO q.a.m. and 1000 mg
PO q.p.m.










FOLLOW-UP CARE:  The patient will followup as an outpatient
with Dr. [**Last Name (STitle) 1327**] with a head CT in two weeks' time.  He will
also followup with his neurologist in [**Hospital3 **].  The
patient's mental status and motor examination was clear at
the time of discharge.




                            [**Name6 (MD) 1339**] [**Last Name (NamePattern4) 1340**], M.D.  [**MD Number(1) 1341**]

Dictated By:[**Last Name (NamePattern1) 5476**]
MEDQUIST36

D:  [**2145-7-9**]  14:20
T:  [**2145-7-9**]  13:30
JOB#:  [**Job Number 35751**]
{'Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, unspecified state of consciousness,Other convulsions,Personal history of malignant neoplasm of brain,Fall from other slipping, tripping, or stumbling'}


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 30-year-old
male with the past medical history of seizures and
oligodendroglioma status post resection in [**2133**], who presents
with a fall and seizure on the morning of admission.  The
patient was in his usual state of health until the morning
when he fell at work.  He does not recall a precipitating
event.  He fell backwards and struck his occiput.  He had
loss of consciousness at the scene.  The patient was brought
to the emergency department.  He received Dilantin times one
gram and Ativan and he stopped seizing.  CT in the emergency
department showed left sided occipital and temporal subdural
hematomas.  Hairline fracture was noted at the clivus.  The
patient reports no headache at this time.  His last seizure
was approximately one year ago and the seizures have been
well controlled with Tegretol.  He presents for evaluation
and treatment of the subdural hematoma.  The patient has
residual right hemiparesis from surgery.

MEDICAL HISTORY: 1.  Oligodendroglioma status post resection in [**2133**].
2.  Seizures.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient is allergic to ERYTHROMYCIN.

PHYSICAL EXAM: 

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: The patient works in college in
administration. 

### Response:
{'Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, unspecified state of consciousness,Other convulsions,Personal history of malignant neoplasm of brain,Fall from other slipping, tripping, or stumbling'}
