CHIEF COMPLAINT: Ped-struck.

PRESENT ILLNESS: This is an 82-year-old gentleman
with no past medical history who was [**Location (un) 70516**]and was struck by a car.  The patient hit the frame of the
window in car causing a shattered windshield and fell back
onto the pavement.  Had positive loss of consciousness at the
scene, but was awake and cooperative since arrival.

MEDICAL HISTORY: None.

MEDICATION ON ADMISSION: 

ALLERGIES: None.

PHYSICAL EXAM: 

FAMILY HISTORY: None.

SOCIAL HISTORY: The patient is a nonsmoker.  One glass of
wine with meals daily.  No drugs.  Lives with wife in [**Name (NI) 392**].
Works currently as a host at a local restaurant.
Other and unspecified cerebral laceration and contusion, without mention of open intracranial wound, with loss of consciousness of unspecified duration,Motor vehicle traffic accident involving collision with pedestrian injuring pedestrian,Street and highway accidents,Open wound of forehead, without mention of complication
Brain lacer NEC-coma NOS,Mv coll w pedest-pedest,Accid on street/highway,Open wound of forehead
Admission Date: [**2133-1-29**]        Discharge Date: [**2133-2-1**]


Service:  TRA


CHIEF COMPLAINT:  Ped-struck.

HISTORY OF PRESENT ILLNESS:  This is an 82-year-old gentleman
with no past medical history who was [**Location (un) 70516**]and was struck by a car.  The patient hit the frame of the
window in car causing a shattered windshield and fell back
onto the pavement.  Had positive loss of consciousness at the
scene, but was awake and cooperative since arrival.

PAST MEDICAL HISTORY:  None.

PAST SURGICAL HISTORY:  Hernia repair.

ALLERGIES:  None.

MEDICATIONS PRIOR TO ADMISSION:  None.

SOCIAL HISTORY:  The patient is a nonsmoker.  One glass of
wine with meals daily.  No drugs.  Lives with wife in [**Name (NI) 392**].
Works currently as a host at a local restaurant.

FAMILY HISTORY:  None.

REVIEW OF SYSTEMS:  Upon presentation complains of back of
head hurting and right leg pain.  Otherwise, no other
complaints.

PHYSICAL EXAMINATION:  Vitals upon presentation; temperature
97.8, blood pressure 139/75, heart rate 123, respiratory rate
18, and O2 saturation was 90% on room air.  He was
comfortable.  In no acute distress.  Pupils were 3 to 2.  His
extraocular motions were intact.  He had a large hematoma of
the left forehead.  It was bleeding from the occipital area.
Neck collar was in place.  Lungs were clear bilaterally to
auscultation.  Cardiac with regular rate and rhythm.
Positive S1/S2.  Abdomen was soft, nontender, nondistended.
Positive bowel sounds.  Extremities were warm and well
perfused.  Mental status; the patient was awake, and alert,
and cooperative with exam.  Normal affect.  He was oriented
to person, place, and date.  He recalled [**4-11**] objects at 5
minutes.

HOSPITAL COURSE:  The patient was then admitted to the trauma
surgical team under the care of Dr. [**First Name4 (NamePattern1) 518**] [**Last Name (NamePattern1) 519**].  He was
then admitted to the trauma ICU.  A surgery consult was
obtained on the 21st of [**2132**] upon his presentation to the
trauma bay, where a CT of the head was obtained which showed
a subarachnoid hemorrhage and multiple bilateral cerebral
sulci as well as bilateral cisterns and a left frontal
hygroma versus hematoma was also identified.  The patient was
admitted to trauma SICU with q.1 neuro checks overnight.  He
was loaded with 1 gram of Dilaudid, then 100 mg t.i.d..  It
was agreed to keep the systolic blood pressure less than 140.
He was to have a repeat CT scan in the morning.  The patient
also had a trauma series which showed a mild __________  of
the thoracic aorta and degenerative changes within the
thoracic spine.  There were also degenerative changes within
the lower lumbosacral spine and SI joints.  Both hips were
anatomical, and there was fracture identified.  He also had a
CT of C-spine which was obtained in the trauma bay on
[**2133-1-29**], which showed no acute fracture or
malalignment.  Lucencies within the spinous processes of C2-
C3 and C3-C4, for which clinical correlation was warranted.
There were degenerative changes along his cervical spine.
The patient also had a CT abdomen and pelvis and chest; which
showed no evidence of traumatic injury in the chest, abdomen,
pelvis.  Bilateral hypodensities in the kidneys, which were
incompletely characterized and tiny liver hypodensities which
were incompletely identified as well.  The patient complained
of shoulder pain upon presentation of the left shoulder;
which showed that the left glenohumeral joint was congruent.
He also underwent a CT of the head which was obtained 6 hours
after initial presentation; which showed a stable
subarachnoid hemorrhage of the cerebral convexities
bilaterally.  The subarachnoid hemorrhages in the basal
cisterns and sylvan fissures were less visible on this second
study versus the first.  The patient remained in the trauma
ICU for 4 days of his stay, where he had q.1 neuro checks.
He did fine post injury without any complications.  He did
sustain a laceration along his occipital bone which was
repaired in the trauma bay.  The patient did well.  He
tolerated the procedure fine without any complications.  He
was sutured in an interrupted fashion.  Presentation along
with discharge, of note, I was not physically present upon
the discharge of this patient.  However, he was reportedly
stable by discharging physician.  [**Name10 (NameIs) **] was afebrile.  Vital
signs stable.  Clear lungs.  A regular rate and rhythm of the
heart.  Belly soft.  Wound was well approximated along the
head.  No evidence of erythema, or drainage, or pus.  There
was no evidence of infection along that wound.  He did remain
having good range of motion of the left shoulder, and his
head CT was unremarkable.  The patient was discharged without
a collar given the fact that his CT of C-spine showed no
acute fracture or malalignment.  His creatinine upon
presentation in the ED was 36.2.  However, it did drop to
25.8 upon discharge.  His creatinine remained stable
throughout his hospital course.  His glucose levels actually
improved.  Potassium and sodium remained unremarkable.  No
acute changes.  The patient remained stable throughout his
hospital course without any complications.  Required no blood
transfusions or any infusions of any type.

CONDITION ON DISCHARGE:  He was discharged in a stable
condition.  He was ambulating and tolerating p.o.'s by report
from the discharged physician.

DISCHARGE INSTRUCTIONS:  He was told to come back for fevers
greater than 101.5, increased pain, inability to walk, any
nausea, vomiting, abdominal pain, any lightheadedness or
dizziness he may experience, any change in mental status.  He
was told to follow up to have his sutures removed on his
head, which he did.  The patient was also told to follow up
with repeat CT head within a couple weeks and to follow up
with neurosurgery.

DISCHARGE MEDICATIONS:  The patient was discharged with
Dilantin to continue for several days; presumably past the
hospital course for his subarachnoid hemorrhage.



                        [**First Name11 (Name Pattern1) 518**] [**Last Name (NamePattern4) **], [**MD Number(1) 17554**]

Dictated By:[**Last Name (NamePattern1) 29268**]
MEDQUIST36
D:  [**2133-3-13**] 17:37:48
T:  [**2133-3-13**] 18:48:50
Job#:  [**Job Number 70517**]
{'Other and unspecified cerebral laceration and contusion, without mention of open intracranial wound, with loss of consciousness of unspecified duration,Motor vehicle traffic accident involving collision with pedestrian injuring pedestrian,Street and highway accidents,Open wound of forehead, without mention of complication'}


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: Ped-struck.

PRESENT ILLNESS: This is an 82-year-old gentleman
with no past medical history who was [**Location (un) 70516**]and was struck by a car.  The patient hit the frame of the
window in car causing a shattered windshield and fell back
onto the pavement.  Had positive loss of consciousness at the
scene, but was awake and cooperative since arrival.

MEDICAL HISTORY: None.

MEDICATION ON ADMISSION: 

ALLERGIES: None.

PHYSICAL EXAM: 

FAMILY HISTORY: None.

SOCIAL HISTORY: The patient is a nonsmoker.  One glass of
wine with meals daily.  No drugs.  Lives with wife in [**Name (NI) 392**].
Works currently as a host at a local restaurant. 

### Response:
{'Other and unspecified cerebral laceration and contusion, without mention of open intracranial wound, with loss of consciousness of unspecified duration,Motor vehicle traffic accident involving collision with pedestrian injuring pedestrian,Street and highway accidents,Open wound of forehead, without mention of complication'}
