CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 63-year-old
right-handed gentleman who was originally diagnosed with
melanoma in [**2179-9-2**].  Since his diagnosis, he
underwent a wide excision of the left shin melanoma with
sentinel lymph node biopsy in [**2179-10-3**] and
additional lymph node removal in [**2180-2-2**].  He also
had stereotactic radiosurgery on [**2181-3-28**] to a left
medial frontal lesion and stereotactic radiosurgery to a
vermis lesion in [**2181-6-2**].  Since then, he has developed
recurrence of the left frontal brain metastasis versus
radiation necrosis.  The patient was admitted status post
left frontal craniotomy for resection of tumor versus
necrosis.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Secondary malignant neoplasm of brain and spinal cord,Personal history of malignant melanoma of skin,Other ill-defined cerebrovascular disease,Radiological procedure and radiotherapy as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled
Sec mal neo brain/spine,Hx-malig skin melanoma,Cerebrovasc disease NEC,Abn react-radiotherapy,DMII wo cmp nt st uncntr
Admission Date: [**2181-8-8**]        Discharge Date: [**2181-8-14**]

Date of Birth:  [**2117-5-27**]        Sex:  M

Service:  NSU


HISTORY OF PRESENT ILLNESS:  The patient is a 63-year-old
right-handed gentleman who was originally diagnosed with
melanoma in [**2179-9-2**].  Since his diagnosis, he
underwent a wide excision of the left shin melanoma with
sentinel lymph node biopsy in [**2179-10-3**] and
additional lymph node removal in [**2180-2-2**].  He also
had stereotactic radiosurgery on [**2181-3-28**] to a left
medial frontal lesion and stereotactic radiosurgery to a
vermis lesion in [**2181-6-2**].  Since then, he has developed
recurrence of the left frontal brain metastasis versus
radiation necrosis.  The patient was admitted status post
left frontal craniotomy for resection of tumor versus
necrosis.

SUMMARY OF HOSPITAL COURSE:  Postoperatively, his vital signs
were stable.  He was afebrile.  He was awake, alert, and
oriented times two (to name and place).  He was without
complaints.  He had a slight frontal headache.  His vital
signs revealed temperature was 99.6, his heart rate was 69,
his blood pressure was 115 to 165/55 to 70, his respiratory
rate was 12 to 20, and his oxygen saturation was 97 percent
on room air.

The patient underwent resection of the left frontal
metastatic melanoma and radiation necrosis.  His pupils
equal, round and reactive to light and accommodation.  He had
no facial asymmetry.  His tongue was midline.  His smile was
symmetric.  His sternocleidomastoid strength was greater on
the right than on the left.  He had no drift.  His fine
finger movements were intact.  His strength was [**6-6**]
throughout in all muscle groups.  His sensation was intact to
light touch.

He remained in the Post Anesthesia Care Unit overnight where
he remained neurologically stable.  He was oriented to place
but not to date.  Naming was intact.  His grasps were full.
He had no drift.  He was transferred to the regular floor.
He Decadron was slowly weaned.  He was followed by Physical
Therapy and Occupational Therapy and found to require a short
rehabilitation stay prior to discharge to home.

He had a follow-up magnetic resonance imaging scan which
showed good excision of the tumor and necrosis.  The patient
had slight confusion on postoperative day two.  He had a head
computer tomography which showed no change.  The patient's
mental status has remained stable.  He was awake, alert, and
oriented times two, but he was sometimes somewhat a little
confused; although this was improving.  His balance was still
somewhat off, and his safety awareness was slightly
decreased.  The patient would benefit for a short
rehabilitation stay prior to discharge to home.

MEDICATIONS ON DISCHARGE:
1. Decadron 2 mg by mouth q.8h. for two days and then
   Decadron 2 mg by mouth q.12h. (starting on [**2181-8-15**])
   and stay at this dose.
2. Percocet one to two tablets by mouth q.4h. as needed.
3. Famotidine 200 mg by mouth twice per day.
4. Sertraline 150 mg by mouth once per day.
5. Atorvastatin 5 mg by mouth once per day.
6. Hydrochlorothiazide 12.5 mg by mouth once per day.
7. Ramipril 10 mg by mouth once per day.
8. Senna one tablet by mouth twice per day as needed.
9. Colace 100 mg by mouth twice per day.
10.      Insulin sliding scale - the patient has not required
   coverage.
11.      Dilantin 100 mg by mouth three times per day.


CONDITION ON DISCHARGE:  The patient's condition was stable
at the time of discharge.

DISCHARGE FOLLOWUP:  The patient was to follow up in the
Brain [**Hospital 341**] Clinic in two weeks.  The staples should be
removed on postoperative day 10; his surgery date was [**2181-8-8**].  The staples should be removed on [**2181-8-18**].



                        [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], [**MD Number(1) 8632**]

Dictated By:[**Last Name (NamePattern1) 6583**]
MEDQUIST36
D:  [**2181-8-13**] 15:55:08
T:  [**2181-8-13**] 16:42:54
Job#:  [**Job Number 15007**]
{'Secondary malignant neoplasm of brain and spinal cord,Personal history of malignant melanoma of skin,Other ill-defined cerebrovascular disease,Radiological procedure and radiotherapy as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled'}


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: The patient is a 63-year-old
right-handed gentleman who was originally diagnosed with
melanoma in [**2179-9-2**].  Since his diagnosis, he
underwent a wide excision of the left shin melanoma with
sentinel lymph node biopsy in [**2179-10-3**] and
additional lymph node removal in [**2180-2-2**].  He also
had stereotactic radiosurgery on [**2181-3-28**] to a left
medial frontal lesion and stereotactic radiosurgery to a
vermis lesion in [**2181-6-2**].  Since then, he has developed
recurrence of the left frontal brain metastasis versus
radiation necrosis.  The patient was admitted status post
left frontal craniotomy for resection of tumor versus
necrosis.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Secondary malignant neoplasm of brain and spinal cord,Personal history of malignant melanoma of skin,Other ill-defined cerebrovascular disease,Radiological procedure and radiotherapy as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled'}
