CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 41-year-old
female, status post fall down 14 stairs.  She reported
headache and minimal awareness post fall.  She has poor
recall of events.  She complained of headache behind the
right eye.  Her husband reported hearing the patient scream
and found her down approximately 12:15 pm on [**2144-12-26**].

MEDICAL HISTORY: 1. [**Doctor Last Name 27210**] syndrome.
2. Hypothyroidism.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with loss of consciousness of unspecified duration,Accidental fall on or from other stairs or steps,Home accidents,Unspecified acquired hypothyroidism,Gonadal dysgenesis
Cl skul base fx-coma NOS,Fall on stair/step NEC,Accident in home,Hypothyroidism NOS,Gonadal dysgenesis
Admission Date:  [**2145-11-25**]       Discharge Date:  [**2145-11-30**]

Date of Birth:   [**2103-2-4**]       Sex:  F

Service:  NEUROSURGERY

HISTORY OF PRESENT ILLNESS:  The patient is a 41-year-old
female, status post fall down 14 stairs.  She reported
headache and minimal awareness post fall.  She has poor
recall of events.  She complained of headache behind the
right eye.  Her husband reported hearing the patient scream
and found her down approximately 12:15 pm on [**2144-12-26**].

PAST MEDICAL HISTORY:
1. [**Doctor Last Name 27210**] syndrome.
2. Hypothyroidism.

MEDICATIONS ON ADMIT:
1. Provera.
2. Synthroid.

LABS ON ADMISSION:  7.6 white count, 45.3, 286, 12.5, 20 and
1.0 for INR, 141, 4.1, 105, 24, BUN and creatinine not
recorded, glucose 141.

EXAM:  The patient was alert and oriented x 4.  She was
awake.  Cranial nerves II through XII were intact.  She was
moving all extremities.  Her grips were full bilaterally.
Her IPs were full bilaterally.

Head CT demonstrated an epidural hematoma over the right
temporal lobe with compression of brain, as well as right
temporal bone fracture and blood in the left sylvian fissure,
as well as a fair amount of traumatic subarachnoid in the
basal cistern.  C-spine CT at that time was negative.

ASSESSMENT AND PLAN:  The patient was seen by the trauma
surgery service and she was hard collared on admission.
Because of the patient's epidural hematoma and temporal bone
fracture, it was decided to take the patient emergently to
the OR.

HOSPITAL COURSE:  On [**2145-11-25**], the patient was taken to the
OR by Dr. [**Last Name (STitle) 1327**] wherein she underwent decompression of her
right temporal epidural hematoma.  She tolerated the
procedure well with minimal blood loss.  Postoperatively, she
was transferred to the Neuro ICU.  Overnight, from
postoperative day #0 to postoperative day #1, the patient
received a CT angiogram which demonstrated no aneurysmal or
vascular malformation as a cause for her extensive
subarachnoid hemorrhage.  It was felt at that time that the
subarachnoid hemorrhage was due only to her traumatic injury.
Overnight, in the Surgical ICU, the patient did well.  She
was extubated and awake.  Postoperatively, she remained awake
through the night until postoperative day #1, and was alert
and oriented and following commands.

On postoperative day #1, the patient received a repeat CAT
scan which again demonstrated diffuse subarachnoid
hemorrhage, as well as good decompression of the temporal
lobe hematoma.  It was decided at that point to move the
patient from the Surgical ICU to the floor.

On the floor, the patient was evaluated by the physical
therapy services and was found to be able to ambulate and do
stairs on her own.  It was decided, given this, that the
patient would be safe for discharge to home with supervision.

On postoperative day #5, with the patient awake, alert,
ambulatory, tolerating a regular diet, and cleared by the
physical therapy services, it was decided to discharge the
patient to home.

DISCHARGE DIAGNOSES:
1. Right temporal bone fracture.
2. Right epidural hematoma.
3. Traumatic subarachnoid hemorrhage.
4. Secondary diagnoses in the past medical history, as listed
above.

DISCHARGE MEDICATIONS:
1. Synthroid 75 mcg po qd.
2. Dilantin 100 mg po tid to continue for a total 7-day
postoperative course.
3. Percocet 1-2 tabs po q 4-6 h prn pain.
4. Colace 100 mg po bid.
5. The patient is to resume all preop medications.

FOLLOW-UP:  Approximately 7-10 days postoperatively for
staple removal, and in 4 weeks with Dr. [**Last Name (STitle) 1327**] with repeat
CAT scan.




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

Dictated By:[**Name8 (MD) 16207**]
MEDQUIST36

D:  [**2145-11-30**]  11:29
T:  [**2145-11-30**]  11:43
JOB#:  [**Job Number 53746**]
{'Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with loss of consciousness of unspecified duration,Accidental fall on or from other stairs or steps,Home accidents,Unspecified acquired hypothyroidism,Gonadal dysgenesis'}


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 41-year-old
female, status post fall down 14 stairs.  She reported
headache and minimal awareness post fall.  She has poor
recall of events.  She complained of headache behind the
right eye.  Her husband reported hearing the patient scream
and found her down approximately 12:15 pm on [**2144-12-26**].

MEDICAL HISTORY: 1. [**Doctor Last Name 27210**] syndrome.
2. Hypothyroidism.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with loss of consciousness of unspecified duration,Accidental fall on or from other stairs or steps,Home accidents,Unspecified acquired hypothyroidism,Gonadal dysgenesis'}
