CHIEF COMPLAINT: Headache, nonresponsive.

PRESENT ILLNESS: A 47-year-old Spanish speaking
man, with a history of hypertension, presented to outside
hospital after being found on the floor at work.  EMS reports
not moving left side.  At approximately 6:15 am, the patient
was seen at work and was well.  Several minutes later he was
found on floor by time clock, complaining of headache.  When
EMS arrived at 6:31, the patient was unresponsive.  They
noted that he was not moving the left side.  He was taken to
[**Hospital3 1443**] Hospital and intubated for airway
protection.  At outside hospital, systolic blood pressure
into 120's, and transferred to [**Hospital1 18**] with concern for acute
stroke.  Per EMS during transfer, the patient spontaneously
moving right side, not left.  Systolic blood pressure's 170's-
180's.  Pupils were pinpoint bilaterally.  On arrival, blood
pressure in 180's and was fighting ventilator, so was started
on propofol and given paralytics.

MEDICAL HISTORY: Hypertension.

MEDICATION ON ADMISSION: 

ALLERGIES: Unknown.  Sister thinks none.

PHYSICAL EXAM: 

FAMILY HISTORY: Unknown.

SOCIAL HISTORY: Lives with another sister who is currently
on vacation in [**Country 13622**] Republic.  Per family, occasional
ETOH, occasional tobacco.  No cocaine or other drugs.  Works
in bakery.  He plays baseball every Sunday.
Intracerebral hemorrhage,Pneumonia, organism unspecified,Compression of brain,Unspecified essential hypertension
Intracerebral hemorrhage,Pneumonia, organism NOS,Compression of brain,Hypertension NOS
Admission Date: [**2108-7-20**]        Discharge Date: [**2108-8-22**]

Date of Birth:  [**2061-6-18**]        Sex:  M

Service:  NSU


CHIEF COMPLAINT:  Headache, nonresponsive.

History obtained from medical record and patient's sister,
[**Name (NI) **] [**Name (NI) 58124**] [**Telephone/Fax (1) 58125**], Spanish speaking only.

HISTORY OF PRESENT ILLNESS:  A 47-year-old Spanish speaking
man, with a history of hypertension, presented to outside
hospital after being found on the floor at work.  EMS reports
not moving left side.  At approximately 6:15 am, the patient
was seen at work and was well.  Several minutes later he was
found on floor by time clock, complaining of headache.  When
EMS arrived at 6:31, the patient was unresponsive.  They
noted that he was not moving the left side.  He was taken to
[**Hospital3 1443**] Hospital and intubated for airway
protection.  At outside hospital, systolic blood pressure
into 120's, and transferred to [**Hospital1 18**] with concern for acute
stroke.  Per EMS during transfer, the patient spontaneously
moving right side, not left.  Systolic blood pressure's 170's-
180's.  Pupils were pinpoint bilaterally.  On arrival, blood
pressure in 180's and was fighting ventilator, so was started
on propofol and given paralytics.

REVIEW OF SYMPTOMS:  Family denies any recent illness,
problems, or symptoms.

PAST MEDICAL HISTORY:  Hypertension.

Status post hand surgery about 7 years ago for injury during
MVA.

ALLERGIES:  Unknown.  Sister thinks none.

MEDICATIONS:  Unknown.  Sister reports occasional aspiration.
?Something for blood pressure.

SOCIAL HISTORY:  Lives with another sister who is currently
on vacation in [**Country 13622**] Republic.  Per family, occasional
ETOH, occasional tobacco.  No cocaine or other drugs.  Works
in bakery.  He plays baseball every Sunday.

FAMILY HISTORY:  Unknown.

PHYSICAL EXAM ON ADMISSION:  BP 180/106, heart rate 63,
respiratory rate 18, oxygen saturation 100 percent on
ventilator.
GENERAL:  Appears stated age, intubated, sedated.
HEAD, EARS, EYES, NOSE AND THROAT:  Sclerae anicteric.
LUNGS:  Clear to auscultation anterolaterally.
CARDIOVASCULAR:  Regular rate and rhythm.  Normal S1 and S2.
No murmurs.
ABDOMEN:  Soft, nontender, normoactive bowel sounds.
EXTREMITIES:  No edema.
NEUROLOGIC EXAMINATION - Note:  The patient had received
versed at outside hospital and was started on propofol just
prior to exam.
MENTAL STATUS:  Intubated.  Does not follow commands.  Does
not open eyes to stimulation--see above.
CRANIAL NERVES:  Pupils initially equal, round and reactive
to light, 2 to 1.5 mm bilaterally.  About 20-30 minutes
later, right pupil 7 mm and nonreactive after paralytics
given, left still 2 mm but nonreactive after paralytics
given.  No extraocular movement noted even to passage lateral
rotation.  No facial asymmetry noted.  Normal tone
bilaterally.  Spontaneously moves right side.  Withdraws
right upper extremity briskly.  Withdraws left upper
extremity, but less so.  No response bilaterally in lower
extremities.  Toes were mute.  Unable to test coordination
and gait.

LABS, RADIOLOGY:  Outside hospital labs:  White count 6,
hematocrit 39.5, coags normal, BUN 35, creatinine 2.1,
glucose 180.  LFT's okay.
HEAD CT:  Large greater than 60 ml intraparenchymal right
basal ganglia and thalamic bleed with extension into
ventricles and subarachnoid as well.

At this point, there was concern that this gentleman had a
right-sided basal bleed and a consultation suggestive of
hypertensive etiology, though with presence of subarachnoid
blood there was also some concern for aneurysm.  While in ED,
he developed a dilated, fixed right pupil concerning for a
brainstem compression and herniation.  His ICP was reduced
with ventriculostomy and frequent use of mannitol.

HOSPITAL COURSE:  His hospital course was complicated by
sputum with gram-negative rods, and he failed to wean off of
drain x 2.  VP shunt was placed on [**2108-8-14**].  The patient was
eventually weaned.  A trach was placed, and he was extubated
on the trach.  The patient continued to be unresponsive with
minimal movement to pain on the right side.

The patient to be discharged to long-term care facility.
They should monitor for fevers, chills, nausea, vomiting.  If
any of these occur, they are to contact the physician
[**Name Initial (PRE) 2227**].

DISCHARGE DIAGNOSES:  Right intraparenchymal,
intraventricular basal ganglia and thalamic hemorrhage.

Hypertension.

Status post right hand surgery post motor vehicle accident in
the [**2093**]'s.

FOLLOW UP:  No follow-up is required, but they may follow-up
with Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) 1132**] as needed.

MAJOR SURGICAL PROCEDURES:  Intraventricular drain
placed/ventriculostomy.

DISCHARGE CONDITION:  Poor.  Minimal movement to painful
stimuli.

DISCHARGE MEDICATIONS:
1. Aspirin prn.
2. Bisacodyl suppository prn.
3. Insulin sliding scale.
4. Artificial Tears.
5. Polyvinyl alcohol drops prn.
6. Colace.
7. Heparin subcu 5,000 [**Hospital1 **].
8. Magnesium prn.
9. Lansoprazole 30 mg DR 1 capsule po bid.
10.Nebulizers prn.
11.Clonidine 0.3 mg per 24 h patch weekly, change on
Thursday's.
12.Hydralazine 50 mg tablet po qd.
13.Percocet prn.
14.Labetalol 100 mg 3 tablets po tid.
15.Lorazepam prn.



                        [**Name6 (MD) **] [**Last Name (NamePattern4) 1359**], [**MD Number(1) 1360**]

Dictated By:[**Last Name (NamePattern1) 15649**]
MEDQUIST36
D:  [**2108-8-22**] 11:31:02
T:  [**2108-8-22**] 12:03:56
Job#:  [**Job Number **]


Name:  [**Known lastname 7595**], [**Known firstname **]              Unit No:  [**Numeric Identifier 10782**]

Admission Date: [**2108-7-20**]        Discharge Date: [**2108-9-5**]

Date of Birth:  [**2061-6-18**]        Sex:  M

Service:  NSU


NO DICTATION



                        [**Name6 (MD) **] [**Last Name (NamePattern4) 2483**], [**MD Number(1) 2484**]

Dictated By:[**Last Name (NamePattern1) 2186**]
MEDQUIST36
D:  [**2108-9-5**] 15:16:15
T:  [**2108-9-7**] 05:32:38
Job#:  [**Job Number 10783**]


Name:  [**Known lastname 7595**], [**Known firstname **]              Unit No:  [**Numeric Identifier 10782**]

Admission Date:                   Discharge Date: [**2108-9-5**]

Date of Birth:  [**2061-6-18**]        Sex:  M

Service:  NSU


ADDENDUM:  The patient's discharge was delayed until
[**2108-9-5**].  The patient's condition since [**2108-8-22**], has
been stable, neurologically improving; starting to mouth
words, follow commands.  Following commands on the right.
Left side continues to be plegic.  He was seen by speech and
swallow for a Passy-Muir valve, although the patient did not
tolerate that.  He continues to have a new trache in place
with sutures that are in place.  It should stay in place for
another three weeks and then be removed.  The patient has
been tolerating a 35 percent trache collar and been
tolerating Respalor full strength at 80 cc an hour for tube
feedings and being straight cathed every six to eight hours,
to keep his urine volumes less than 400 cc.

MEDICATIONS AT TIME OF DISCHARGE:
1. Hydralazine 25 p.o. q. a.m. and q.p.m.
2. Labetalol 400 mg p.o. t.i.d.
3. Heparin flush through his PICC line which was inserted on
   [**2108-8-21**].
4. Hydralazine 50 p.o. every four hours.
5. Clonidine patch, three patches q. Thursday.
6. Heparin 5000 units b.i.d.
7. Colace 100 mg p.o. b.i.d.
8. Artifical tears, one to two drops o.u. prn.
9. Lacrilube one o.u. p.r.n.
10.      Insulin sliding scale.
11.      Dulcolax suppository, one p.r. every day prn.
12.      Tylenol 650 p.o. q. Four hours prn.

The patient's condition is stable at the time of discharge.
He will follow-up with Dr. [**Last Name (STitle) 365**] in one month with repeat
head CT at that time.  His condition was stable.



                        [**Name6 (MD) **] [**Last Name (NamePattern4) 2483**], [**MD Number(1) 2484**]

Dictated By:[**Last Name (NamePattern1) 2186**]
MEDQUIST36
D:  [**2108-9-5**] 15:20:05
T:  [**2108-9-7**] 05:31:09
Job#:  [**Job Number 10787**]
{'Intracerebral hemorrhage,Pneumonia, organism unspecified,Compression of brain,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: Headache, nonresponsive.

PRESENT ILLNESS: A 47-year-old Spanish speaking
man, with a history of hypertension, presented to outside
hospital after being found on the floor at work.  EMS reports
not moving left side.  At approximately 6:15 am, the patient
was seen at work and was well.  Several minutes later he was
found on floor by time clock, complaining of headache.  When
EMS arrived at 6:31, the patient was unresponsive.  They
noted that he was not moving the left side.  He was taken to
[**Hospital3 1443**] Hospital and intubated for airway
protection.  At outside hospital, systolic blood pressure
into 120's, and transferred to [**Hospital1 18**] with concern for acute
stroke.  Per EMS during transfer, the patient spontaneously
moving right side, not left.  Systolic blood pressure's 170's-
180's.  Pupils were pinpoint bilaterally.  On arrival, blood
pressure in 180's and was fighting ventilator, so was started
on propofol and given paralytics.

MEDICAL HISTORY: Hypertension.

MEDICATION ON ADMISSION: 

ALLERGIES: Unknown.  Sister thinks none.

PHYSICAL EXAM: 

FAMILY HISTORY: Unknown.

SOCIAL HISTORY: Lives with another sister who is currently
on vacation in [**Country 13622**] Republic.  Per family, occasional
ETOH, occasional tobacco.  No cocaine or other drugs.  Works
in bakery.  He plays baseball every Sunday. 

### Response:
{'Intracerebral hemorrhage,Pneumonia, organism unspecified,Compression of brain,Unspecified essential hypertension'}
