CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 74-year-old
woman who was doing water aerobics on the day of admission,
felt weak and dizzy after getting out of the pool, went home
and then developed left sided headache.  Signs and symptoms
were gradual in onset and in the lateral afternoon she began
having difficulty talking.  Speech was confused.  She was
brought to an outside hospital.  A CT scan showed a left
parietal bleed and the patient was transferred to [**Hospital6 1760**] for further management.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: VITAL SIGNS:  The patient was afebrile.  Blood pressure was
155/83, heart rate 81, respiratory rate 18.
CARDIAC:  Regular rate and rhythm.
LUNGS:  Clear to auscultation.
ABDOMEN:  Soft, nontender, nondistended.
NEUROLOGIC:  Awake and alert with some aphasia.  Speech was
fluent with multiple paraphasic errors.  Comprehension
relatively intact with simple but no complex commands.
Pupils equal, round and reactive to light.  EOMs full.  Face
was symmetric.  Mild right pronator drift.  Formal strength
testing difficult secondary to her lack of comprehension.
Reflexes were symmetric and toes were downgoing bilaterally.

FAMILY HISTORY: 

SOCIAL HISTORY: 
Intracerebral hemorrhage,Unspecified essential hypertension
Intracerebral hemorrhage,Hypertension NOS
Admission Date:  [**2183-6-10**]       Discharge Date:  [**2183-6-16**]

Date of Birth:   [**2108-11-14**]       Sex:  F

Service:  NEUROSURGERY

HISTORY OF PRESENT ILLNESS:  The patient is a 74-year-old
woman who was doing water aerobics on the day of admission,
felt weak and dizzy after getting out of the pool, went home
and then developed left sided headache.  Signs and symptoms
were gradual in onset and in the lateral afternoon she began
having difficulty talking.  Speech was confused.  She was
brought to an outside hospital.  A CT scan showed a left
parietal bleed and the patient was transferred to [**Hospital6 1760**] for further management.

PHYSICAL EXAM:
VITAL SIGNS:  The patient was afebrile.  Blood pressure was
155/83, heart rate 81, respiratory rate 18.
CARDIAC:  Regular rate and rhythm.
LUNGS:  Clear to auscultation.
ABDOMEN:  Soft, nontender, nondistended.
NEUROLOGIC:  Awake and alert with some aphasia.  Speech was
fluent with multiple paraphasic errors.  Comprehension
relatively intact with simple but no complex commands.
Pupils equal, round and reactive to light.  EOMs full.  Face
was symmetric.  Mild right pronator drift.  Formal strength
testing difficult secondary to her lack of comprehension.
Reflexes were symmetric and toes were downgoing bilaterally.

IMAGING:  CT at the outside hospital showed a large right
parietal intraparenchymal bleed.

HOSPITAL COURSE:  The patient was admitted to the
neurosurgery service and scheduled for an MRI with contrast
to rule out an underlying lesion.  She was monitored in the
Intensive Care Unit overnight and transferred to the regular
floor on [**2183-6-11**].  On [**2183-6-12**], the patient was still
densely aphasic with right upper extremity weakness, moving
the lower extremities bilaterally, left greater than right,
awake, but somewhat more lethargic than on the previous day.
The patient had a stat head CT which showed increased
hemorrhage and edema.  The patient was taken to the Operating
Room for left parietal evacuation of intraparenchymal
hemorrhage without intraoperative complication.
Postoperative, the patient was awake and alert, not following
commands, moving all extremities, left greater than right.
The patient was seen by the speech and swallow service, but
was found to be unable to take po's secondary to lethargy.

On [**2183-6-14**], the patient was easily arousable, attentive to
examiner, spoke a few words, poor fluency of speech, but face
was symmetric and again moving her extremities, left greater
than right.  She was seen by physical therapy and
occupational therapy and found to require rehabilitation
prior to discharge home.  On [**2183-6-15**], she was awake and
alert, following commands.  Her dressing was clean, dry and
intact.  She was much improved.  On the 20th, her mental
status was even more improved.  She was speaking more
fluently, although having some word finding difficulties.
She was awake and alert, oriented to her name and following
some simple commands with continued improved strength, still
somewhat weaker on the right than on the left.  She was
stable and ready for transfer to rehabilitation on [**2183-6-16**].

DISCHARGE MEDICATIONS:
1.  Dilantin 100 mg po q8h
2.  Zantac 150 mg po q 12 hours
3.  Levofloxacin 500 mg po q 24 hours x3 days
4.  Percocet 1 to 2 tablets po q4h prn pain

The patient was discharged to rehabilitation in stable
condition with follow up with Dr. [**Last Name (STitle) 6910**] in three to four
weeks' time.  The patient should have her staples removed on
postoperative day #10.  Her surgery was on [**2183-6-12**].  The
patient was in stable condition at the time of discharge.




                            [**Name6 (MD) 6911**] [**Name8 (MD) **], MD  [**MD Number(1) 6913**]

Dictated By:[**Last Name (NamePattern1) 344**]
MEDQUIST36

D:  [**2183-6-16**]  11:57
T:  [**2183-6-16**]  12:02
JOB#:  [**Job Number 41784**]
{'Intracerebral hemorrhage,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: The patient is a 74-year-old
woman who was doing water aerobics on the day of admission,
felt weak and dizzy after getting out of the pool, went home
and then developed left sided headache.  Signs and symptoms
were gradual in onset and in the lateral afternoon she began
having difficulty talking.  Speech was confused.  She was
brought to an outside hospital.  A CT scan showed a left
parietal bleed and the patient was transferred to [**Hospital6 1760**] for further management.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: VITAL SIGNS:  The patient was afebrile.  Blood pressure was
155/83, heart rate 81, respiratory rate 18.
CARDIAC:  Regular rate and rhythm.
LUNGS:  Clear to auscultation.
ABDOMEN:  Soft, nontender, nondistended.
NEUROLOGIC:  Awake and alert with some aphasia.  Speech was
fluent with multiple paraphasic errors.  Comprehension
relatively intact with simple but no complex commands.
Pupils equal, round and reactive to light.  EOMs full.  Face
was symmetric.  Mild right pronator drift.  Formal strength
testing difficult secondary to her lack of comprehension.
Reflexes were symmetric and toes were downgoing bilaterally.

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Intracerebral hemorrhage,Unspecified essential hypertension'}
