CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 66-year-old left-
handed man who presented to the Emergency Room with a left
posterofronta/parietal hemorrhage.  He has had a three to four
month
history of dysequilibrium.  He described dizziness without
vertigo.  No weakness.  Reported no falls.  He reports his
dysequilibrium occurs secondary to sudden rising and he
becomes syncopal a few times a week.  On the day of admission
he felt that he had dysequilibrium again.  He fell down the
stairs.  He hit his head on the right side.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Intracerebral hemorrhage,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Cardiac pacemaker in situ
Intracerebral hemorrhage,DMII wo cmp nt st uncntr,Hypertension NOS,Status cardiac pacemaker
Admission Date: [**2167-9-3**]        Discharge Date: [**2167-9-9**]

Date of Birth:  [**2100-10-1**]        Sex:  M

Service:  NSU


HISTORY OF PRESENT ILLNESS:  This is a 66-year-old left-
handed man who presented to the Emergency Room with a left
posterofronta/parietal hemorrhage.  He has had a three to four
month
history of dysequilibrium.  He described dizziness without
vertigo.  No weakness.  Reported no falls.  He reports his
dysequilibrium occurs secondary to sudden rising and he
becomes syncopal a few times a week.  On the day of admission
he felt that he had dysequilibrium again.  He fell down the
stairs.  He hit his head on the right side.

PHYSICAL EXAMINATION:  Blood pressure 176/80.  The patient
was awake, alert and oriented times three.  Fluent speech.
Repetition was intact.  Naming was intact.  He had positive
extinction on the right side without neglect.  Slight
acalculation.  He did have left-right confusion.  No apparent
ataxia or apraxia was noted.  Cranial nerves II through XII
were grossly intact.  Pupils were 1.5 and trace reactive.
Full extraocular movements.  No diplopia.  Tongue was
midline.  On the upper extremity on the right side, his upper
arm was four plus.  His IP's were four plus.  The remainder
of his lower extremities were five.  His left side, both
upper and lower extremity, were five out of five.  He had a
slight drift to the right.  Sensation was intact to pinprick
and light touch.  There was no [**Doctor Last Name 937**] sign.  He had one
plus reflexes throughout.

HOSPITAL COURSE:  He was admitted to the Intensive Care Unit,
given Decadron 10 mg bolus followed by 4 mg q. 6h.  He was
started on Nipride and an A-line was placed to keep his
systolic blood pressure less than 140.  He had a CT with
contrast and was made NPO and it was felt that he had a
probable brain tumor underlying the bleed.  On his first
admission day he was awake, alert and oriented times three.
Grips and IP's were full.  Pupils were 3 to 2.5 and reactive.
Vital signs:  98.6, blood pressure 121-168 over 60-70's.
White count was 6.6, hematocrit was 31.9, platelet count
183,000.  Sodium 137, potassium 4.6, chloride 108, bicarb 22.
His head CT with and without contrast showed a large
hemorrhagic mass in the left parietal lobe with a brain tumor
versus metastasis.  No other enhancing lesions were seen.
Neurooncology saw Mr. [**Known lastname 745**] and felt that he would need a
full body scan to rule out any malignancies and a bone scan
to evaluate for any further metastases.  They recommended
that he keep his Dilantin level in the range of 15.  A full
body scan showed a focal 13 mm lesion in the left adrenal
gland which measured 17 Hounsfield units on the pre-contrast
scan and slight enhancement on the post-contrast images.
After review by Radiology, Neurooncology felt that this was
not a lesion of importance and was most likely not a
malignancy.  The remainder of his body CT scan was within
normal limits.  He also had a bone scan which was within
normal limits.  There was no evidence of bone metastasis
noted.  On [**2167-9-5**], Mr. [**Known lastname 745**] was transferred out of
the Intensive Care Unit.  He remained awake, alert and
oriented times three.  His blood pressure was within normal
limits.  He was tolerating a regular diet and, once
transferred to the floor, began ambulating with assistance
from the staff and Physical Therapy staff who felt he had
poor standing balance and required maximum assistance to
obtain an upright stance without a walker.  He was able to
moderately ambulate with the walker.  He constantly had a
lean to the right and had difficulty with right foot
clearance.  This appeared to be almost a right-sided neglect.
Given those circumstances, it was recommended that Mr. [**Known lastname 745**]
be sent to a rehabilitation facility to work with physical
therapy regarding his right-sided neglect.

DISCHARGE INSTRUCTIONS:  Include:

He should return to the Emergency Room if a severe headache
occurs or he has any mental status changes or increased
inability to function.  He needs to return to [**Hospital1 346**], report to the fifth floor of the
Clinical Center Building, on Wednesday, [**2167-9-16**], for
stereotactic brain biopsy.  He should have nothing to eat or
drink after midnight for that procedure.

DISCHARGE MEDICATIONS:  Include Tylenol 325 mg one to two
tablets p.o. q. 4-6h., insulin sliding scale due to the fact
that he is on Decadron, atorvastatin calcium 40 mg one p.o.
q. day, escitalopram oxalate 10 mg p.o. q. day, lisinopril 5
mg p.o. q. day, Decadron 4 mg tablets p.o. q. 8h., Lopressor
50 mg p.o. q. day, Protonix 40 mg p.o. q. 24h., Dilantin 100
mg p.o. b.i.d., Dilantin 100 mg p.o. h.s., heparin 5000 units
subcu one t.i.d.  Mr. [**Known lastname 27546**] Dilantin level should be kept
in the range of 15.  His last Dilantin level prior to
discharge was 12.9.

DISCHARGE DIAGNOSES:  Brain mass.

Hypertension.

Status post pacemaker placement.

Diabetes mellitus.

Past history of gastrointestinal bleed.



                        [**Name6 (MD) **] [**Name8 (MD) 739**], MD [**MD Number(2) 2930**]

Dictated By:[**Last Name (NamePattern1) 12790**]
MEDQUIST36
D:  [**2167-9-8**] 16:11:43
T:  [**2167-9-8**] 17:28:46
Job#:  [**Job Number 27547**]
{'Intracerebral hemorrhage,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Cardiac pacemaker in situ'}


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: This is a 66-year-old left-
handed man who presented to the Emergency Room with a left
posterofronta/parietal hemorrhage.  He has had a three to four
month
history of dysequilibrium.  He described dizziness without
vertigo.  No weakness.  Reported no falls.  He reports his
dysequilibrium occurs secondary to sudden rising and he
becomes syncopal a few times a week.  On the day of admission
he felt that he had dysequilibrium again.  He fell down the
stairs.  He hit his head on the right side.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Intracerebral hemorrhage,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Cardiac pacemaker in situ'}
