CHIEF COMPLAINT: Obtunded

PRESENT ILLNESS: 47 year old white female transferred in for sdh from [**Hospital3 **]
hospital. Per [**Location (un) **] it is reported that this pt went to her
parents house today around 12
noon stating she did not feel well. They encouraged her to go
and rest. She was checked on around 2pm and was thought to be
sleeping. She was checked on again at 6pm and it was described
that she was having unusual movments. Her father attempted to
get her up and was unsuccessful. He called EMS. Imaging revealed

MEDICAL HISTORY: Depression
Htn
Seizure disorder

MEDICATION ON ADMISSION: lisinopril 20 / lamictal 50 / singulair and advair

ALLERGIES: Penicillins

PHYSICAL EXAM: O: VS / see ED record
Gen: WD/WN, comfortable, NAD.
HEENT: Pupils:  right 6mm NR / left 4mm NR / conjugate gaze
Neck: in cervical collar
NEURO: vented / off sedation / no corneals / no cough / no EO/
no
commands / decorticate postures / no true localization
E=1 M=3 V=1 GCS 5

FAMILY HISTORY: unkown

SOCIAL HISTORY: etoh daily / probable drug use
Subdural hemorrhage following injury without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness without return to pre-existing conscious level,Unspecified fall,Unspecified essential hypertension,Epilepsy, unspecified, without mention of intractable epilepsy,Myalgia and myositis, unspecified,Alcohol abuse, unspecified,Depressive disorder, not elsewhere classified
Subdural hem-deep coma,Fall NOS,Hypertension NOS,Epilep NOS w/o intr epil,Myalgia and myositis NOS,Alcohol abuse-unspec,Depressive disorder NEC
Admission Date:  [**2188-8-17**]              Discharge Date:   [**2188-8-19**]

Date of Birth:  [**2141-4-12**]             Sex:   F

Service: NEUROSURGERY

Allergies:
Penicillins

Attending:[**First Name3 (LF) 1835**]
Chief Complaint:
Obtunded

Major Surgical or Invasive Procedure:
Right sided cranitomy


History of Present Illness:
47 year old white female transferred in for sdh from [**Hospital3 **]
hospital. Per [**Location (un) **] it is reported that this pt went to her
parents house today around 12
noon stating she did not feel well. They encouraged her to go
and rest. She was checked on around 2pm and was thought to be
sleeping. She was checked on again at 6pm and it was described
that she was having unusual movments. Her father attempted to
get her up and was unsuccessful. He called EMS. Imaging revealed

an extra-axial collection and she was transferred by [**Location (un) **]
to
[**Hospital1 18**].


Past Medical History:
Depression
Htn
Seizure disorder


Social History:
etoh daily / probable drug use

Family History:
unkown


Physical Exam:
O: VS / see ED record
Gen: WD/WN, comfortable, NAD.
HEENT: Pupils:  right 6mm NR / left 4mm NR / conjugate gaze
Neck: in cervical collar
NEURO: vented / off sedation / no corneals / no cough / no EO/
no
commands / decorticate postures / no true localization
E=1 M=3 V=1 GCS 5

On Discharge:
Expired

Pertinent Results:
CT HEAD W/O CONTRAST [**2188-8-18**]
1. Brainstem hemorrhage chronicity compared to preoperative
status is
uncertain.

2. Midline shift as described with probable entrapment of the
left lateral
ventricle.

3. Parafalcine and right posterior subdural hematomas.

4. Right frontotemporal craniectomy with right temporal lobe
resection.

5. Bifrontal pneumocephalus.


Brief Hospital Course:
47 y/o F transferred from [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 5678**] hospital via [**Location (un) **]
after presenting to parents home stating that she was not
feeling well. She was seen to have abnormal movements and
parents called EMS. She was taken to OSH where head CT showed
extra-axial hemorrhage and she was medflighted to [**Hospital1 18**]. Once at
[**Hospital1 **], patient was taken emergently to OR for R craniectomy for
evacuation of R SDH and temporal lobectomy. Bolt was placed
intra-operatively with an opening pressure of 19. Post
operatively, patient exam was L pupil 4 and hippis and R 7 and
fixed. She extensor postures and triple flexion in BLE. Head CT
shows brainstem hemorrhage and entrapment of left lateral
ventricle. Due to poor prognosis, family made the decision to
make patient CMO and NEOB was contact[**Name (NI) **]. The patient passed away
in presence of her family on [**2188-8-19**] at 0815.

Medications on Admission:
lisinopril 20 / lamictal 50 / singulair and advair

Discharge Medications:
N/A

Discharge Disposition:
Expired

Discharge Diagnosis:
Acute Right subdural hematoma


Discharge Condition:
Expired


Discharge Instructions:
N/A

Followup Instructions:
N/A



Completed by:[**2188-8-19**]
{'Subdural hemorrhage following injury without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness without return to pre-existing conscious level,Unspecified fall,Unspecified essential hypertension,Epilepsy, unspecified, without mention of intractable epilepsy,Myalgia and myositis, unspecified,Alcohol abuse, unspecified,Depressive disorder, not elsewhere classified'}


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: Obtunded

PRESENT ILLNESS: 47 year old white female transferred in for sdh from [**Hospital3 **]
hospital. Per [**Location (un) **] it is reported that this pt went to her
parents house today around 12
noon stating she did not feel well. They encouraged her to go
and rest. She was checked on around 2pm and was thought to be
sleeping. She was checked on again at 6pm and it was described
that she was having unusual movments. Her father attempted to
get her up and was unsuccessful. He called EMS. Imaging revealed

MEDICAL HISTORY: Depression
Htn
Seizure disorder

MEDICATION ON ADMISSION: lisinopril 20 / lamictal 50 / singulair and advair

ALLERGIES: Penicillins

PHYSICAL EXAM: O: VS / see ED record
Gen: WD/WN, comfortable, NAD.
HEENT: Pupils:  right 6mm NR / left 4mm NR / conjugate gaze
Neck: in cervical collar
NEURO: vented / off sedation / no corneals / no cough / no EO/
no
commands / decorticate postures / no true localization
E=1 M=3 V=1 GCS 5

FAMILY HISTORY: unkown

SOCIAL HISTORY: etoh daily / probable drug use 

### Response:
{'Subdural hemorrhage following injury without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness without return to pre-existing conscious level,Unspecified fall,Unspecified essential hypertension,Epilepsy, unspecified, without mention of intractable epilepsy,Myalgia and myositis, unspecified,Alcohol abuse, unspecified,Depressive disorder, not elsewhere classified'}
