CHIEF COMPLAINT: headache for 5 days. Patient states the h/a began suddenl when
he was standing at his kitchen sink. Patient states he felt like
something snapped in his head and sustained severe pain. Patient
states he has increased pain w/standing which resolves some when
lying flat

PRESENT ILLNESS: 34yo M h/o etoh abuse, glucose intolerance with postprandial
hypoglycemia who was in USOH Monday evening washing his hands
when he suddenly felt a sharp, [**9-11**] pain in the front of his
head R>L, so severe as to cause him to drop to his knees. His
right leg at this time felt numb, "extremely asleep" - he could
lift it a move it but it did not feel as responsive as it should
for about 5 minutes, before returning completely to normal. He
lay down on the living room floor in extreme pain and took 800mg
of motrin and went to bed. Pain was sharp and non-throbbing and
was worse on standing, relieved somewhat by lying down.

MEDICAL HISTORY: Brachial plexopathy r arm in [**2157**] s/p a lifting accident
Central serous retinopathy
Glucose intolerance (postprandial hypoglycemia)

MEDICATION ON ADMISSION: Flonase
MVI

ALLERGIES: Sulfa (Sulfonamides) / Dilantin

PHYSICAL EXAM: 97.5 132/96 46 12 97%
Gen lying in bed in intermittent distress due to pain
HEENT supple, FROM. Negative Brudzinski
CV rrr
Pulm ctab
Abd soft nt/nd +bs
Ext no edema

FAMILY HISTORY: married wife [**Name (NI) 698**] [**Telephone/Fax (1) 68968**]

SOCIAL HISTORY: works in the [**Location (un) **] building, smokes 1/2-1ppd x 18yrs. No
other drugs. Etoh as above.
Subarachnoid hemorrhage,Other abnormal glucose
Subarachnoid hemorrhage,Abnormal glucose NEC
Admission Date:  [**2164-9-2**]              Discharge Date:   [**2164-9-2**]

Date of Birth:  [**2130-6-23**]             Sex:   M

Service: NEUROLOGY

Allergies:
Sulfa (Sulfonamides) / Dilantin

Attending:[**First Name3 (LF) 5018**]
Chief Complaint:
headache for 5 days. Patient states the h/a began suddenl when
he was standing at his kitchen sink. Patient states he felt like
something snapped in his head and sustained severe pain. Patient
states he has increased pain w/standing which resolves some when
lying flat

Major Surgical or Invasive Procedure:
none

History of Present Illness:
34yo M h/o etoh abuse, glucose intolerance with postprandial
hypoglycemia who was in USOH Monday evening washing his hands
when he suddenly felt a sharp, [**9-11**] pain in the front of his
head R>L, so severe as to cause him to drop to his knees. His
right leg at this time felt numb, "extremely asleep" - he could
lift it a move it but it did not feel as responsive as it should
for about 5 minutes, before returning completely to normal. He
lay down on the living room floor in extreme pain and took 800mg
of motrin and went to bed. Pain was sharp and non-throbbing and
was worse on standing, relieved somewhat by lying down.

Monday night, he woke up with N/V several times. Tuesday
morning,
he awoke, still in pain and his neck was stiff; pain now spread
through his entire head and to his neck. He felt pain/pressure
in
his ears and felt that sounds were muffled. He again took motrin
and went to work. He noticed that on standing, he lost
peripheral
vision in the right eye; this has recurred throughout the week.

He called his PCP who thought these episodes were migraines
(though the patient has never had them - his headache history
includes only a post-LP headache). N/V continued Tuesday night
and into Wednesday morning and evening. Thursday and Friday
passed much the same. When it did not remit by Saturday, he
sought medical attention in the ED.

Over the past few days, he has also noticed pain on looking to
the left or right, and less so on looking down. He is fatigued
this week from not sleeping well but felt no excessive fatigue
lately, before these episodes. Pain is also felt down his spine
and in his tailbone.

Review of systems is otherwise negative, including neurologic
deficits: no weakness/numbness/diplopia/dysarthria/dysphagia; no
incoordination. No cough or illnesses recently, no weight loss.

He drank 1 pint a day until two weeks ago; he was due tomorrow
in
a meeting to help recovering alcoholics.


Past Medical History:
Brachial plexopathy r arm in [**2157**] s/p a lifting accident
Central serous retinopathy
Glucose intolerance (postprandial hypoglycemia)


Social History:
works in the [**Location (un) **] building, smokes 1/2-1ppd x 18yrs. No
other drugs. Etoh as above.

Family History:
married wife [**Name (NI) 698**] [**Telephone/Fax (1) 68968**]

FH: negative for aneurysms, kidney disease


Physical Exam:
97.5 132/96 46 12 97%
Gen lying in bed in intermittent distress due to pain
HEENT supple, FROM. Negative Brudzinski
CV rrr
Pulm ctab
Abd soft nt/nd +bs
Ext no edema

NEURO
MS Awake, alert. Fully oriented. [**Doctor Last Name 1841**] backwards. Speech normal,
naming intact, repetition intact. No neglect. No apraxia. Luria
intact b/l.

CN VFF no extinction. EOM full no diplopia or nystagmus. Facial
sensation intact LT and PP. Full facial strength. Hearing
intact.
Palate rises symmetrically. Shrug [**4-6**]. Tongue midline and agile.

Motor normal bulk and tone throughout. No pronator drift
  D B T WE FE FF IP Q H DF PF

Sensory intact to LT,PP,JPS,vibration throughout. No extinction.

Coordination intact FTN, HTS b/l.

Gait narrow stance and gait


Pertinent Results:
[**2164-9-2**] 07:58AM   WBC-14.8* RBC-4.42* HGB-13.7* HCT-40.9 MCV-93
MCH-31.0 MCHC-33.5 RDW-13.4
[**2164-9-2**] 05:10AM URINE  bnzodzpn-NEG barbitrt-NEG opiates-POS
(got dilaudid) cocaine-NEG amphetmn-NEG mthdone-NEG

Brief Hospital Course:
admitted to ER on [**9-1**] after 5 days of headache, CT done results
showed intraparechymal hemmorage (8mm x 4mm) extending into
carotids transferred to SICU @ 0700 on [**2164-9-2**], given dilaudid
1mg x 3, to be transferred to [**Hospital6 **] for further
evaluation and possible coil after MRI/A found ACA/MCA aneurysm.


Will start on keppra 500mg po bid, as per [**Hospital1 112**] request. No
seizures have been noted. Neuro exam, including cn I, is normal.

Medications on Admission:
Flonase
MVI

Discharge Medications:
Levetiracetam 500 mg PO BID
Pantoprazole 40 mg PO Q24H
Multivitamins 1 CAP PO DAILY
Thiamine HCl 100 mg PO DAILY
Folic Acid 1 mg PO DAILY
Oxycodone-Acetaminophen [**12-5**] TAB PO Q4-6H:PRN
Nicotine Patch 14 mg TD DAILY  10
Fluticasone Propionate Nasal 1 SPRY NU DAILY
Labetalol HCl 10 mg IV Q6H:PRN for sbp>160
Lorazepam 0.5 mg IV Q4H:PRN per CIWA scale


Discharge Disposition:
Extended Care

Facility:
transferred to [**Hospital1 112**]

Discharge Diagnosis:
intracerebral hemmorage
ruptured brain aneurysm

Discharge Condition:
Critical

Discharge Instructions:
None

Followup Instructions:
None

                             [**Name6 (MD) 4267**] [**Last Name (NamePattern4) 4268**] MD, [**MD Number(3) 5023**]

Completed by:[**2164-9-2**]
{'Subarachnoid hemorrhage,Other abnormal glucose'}


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 for 5 days. Patient states the h/a began suddenl when
he was standing at his kitchen sink. Patient states he felt like
something snapped in his head and sustained severe pain. Patient
states he has increased pain w/standing which resolves some when
lying flat

PRESENT ILLNESS: 34yo M h/o etoh abuse, glucose intolerance with postprandial
hypoglycemia who was in USOH Monday evening washing his hands
when he suddenly felt a sharp, [**9-11**] pain in the front of his
head R>L, so severe as to cause him to drop to his knees. His
right leg at this time felt numb, "extremely asleep" - he could
lift it a move it but it did not feel as responsive as it should
for about 5 minutes, before returning completely to normal. He
lay down on the living room floor in extreme pain and took 800mg
of motrin and went to bed. Pain was sharp and non-throbbing and
was worse on standing, relieved somewhat by lying down.

MEDICAL HISTORY: Brachial plexopathy r arm in [**2157**] s/p a lifting accident
Central serous retinopathy
Glucose intolerance (postprandial hypoglycemia)

MEDICATION ON ADMISSION: Flonase
MVI

ALLERGIES: Sulfa (Sulfonamides) / Dilantin

PHYSICAL EXAM: 97.5 132/96 46 12 97%
Gen lying in bed in intermittent distress due to pain
HEENT supple, FROM. Negative Brudzinski
CV rrr
Pulm ctab
Abd soft nt/nd +bs
Ext no edema

FAMILY HISTORY: married wife [**Name (NI) 698**] [**Telephone/Fax (1) 68968**]

SOCIAL HISTORY: works in the [**Location (un) **] building, smokes 1/2-1ppd x 18yrs. No
other drugs. Etoh as above. 

### Response:
{'Subarachnoid hemorrhage,Other abnormal glucose'}
