CHIEF COMPLAINT: The patient presented to the Emergency
Department with the worst headache of her life.

PRESENT ILLNESS: The patient is a 29-year-old
female who was previously healthy who presented with the
worst headache of her life starting at 12:30 p.m. on the day
of admission while running on a treadmill.  The headache was
sudden in onset with associated neck stiffness and
photophobia.  The patient experienced nausea and vomiting and
bilateral lower extremity weakness.  Her gait remained
intact.  She denied numbness or tingling.  She denied loss of
consciousness, and she denied any trauma to the head or the
rest of her body.  She denied upper extremity weakness.  The
patient is a nonsmoker with no family history of subarachnoid
or any other head bleeds.

MEDICAL HISTORY: None.

MEDICATION ON ADMISSION: Diflucan as needed.

ALLERGIES: ASPIRIN.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Subarachnoid hemorrhage
Subarachnoid hemorrhage
Admission Date:  [**2117-10-12**]     Discharge Date:  [**2117-10-19**]

Date of Birth:   [**2087-12-15**]     Sex:  F

Service:  Neurosurgery

CHIEF COMPLAINT:  The patient presented to the Emergency
Department with the worst headache of her life.

HISTORY OF PRESENT ILLNESS:  The patient is a 29-year-old
female who was previously healthy who presented with the
worst headache of her life starting at 12:30 p.m. on the day
of admission while running on a treadmill.  The headache was
sudden in onset with associated neck stiffness and
photophobia.  The patient experienced nausea and vomiting and
bilateral lower extremity weakness.  Her gait remained
intact.  She denied numbness or tingling.  She denied loss of
consciousness, and she denied any trauma to the head or the
rest of her body.  She denied upper extremity weakness.  The
patient is a nonsmoker with no family history of subarachnoid
or any other head bleeds.

The patient reports having a headache off and on for the past
two months, but not to the level of severity as it was on
admission.

PAST MEDICAL HISTORY:  None.

PAST SURGICAL HISTORY:   Left ovarian cystectomy.

MEDICATIONS ON ADMISSION:  Diflucan as needed.

ALLERGIES:  ASPIRIN.

PHYSICAL EXAMINATION ON PRESENTATION:  Physical examination
on admission revealed vital signs with a temperature of 96.8
degrees Fahrenheit, her heart rate was 78, her blood pressure
was 116/71, her respiratory rate was 16, and her oxygen
saturation was 100% on room air.  In general, the patient was
alert and oriented times three.  She was mildly
uncomfortable.  The pupils were equal, round, and reactive to
light and accommodation.  The extraocular movements were
intact.  The patient showed no pronator drift.  Motor
strength was [**4-12**] in the bilateral upper and lower
extremities.  Her sensory examination was intact bilaterally
to light touch.

PERTINENT LABORATORY VALUES ON PRESENTATION:   Laboratories
on admission revealed the patient's white blood cell count
was 10.3, her hematocrit was 37.4, and her platelets were
219.

PERTINENT RADIOLOGY/IMAGING:  Her head computed tomography on
admission revealed positive subarachnoid blood (right greater
than left) and mild hydrocephalus.

BRIEF SUMMARY OF HOSPITAL COURSE:   The patient was admitted
to the Surgical Intensive Care Unit and was typed and crossed
for 4 units of packed red blood cells.  She was started on
Decadron 10 mg every six hours.  She was started on normal
saline at 80 cc per hour.  She was placed 1-hour neurologic
checks and started on amlodipine 60 mg every four hours.

A computed tomography angiogram of her head was obtained.
The computed tomography angiogram showed no evidence of
aneurysm in the circle of [**Location (un) 431**] or its major branches.  The
vertebral and basilar arteries were intact, and there was no
active extravasation identified.

The patient remained stable overnight.  On hospital day two
(on [**2117-10-13**]), the patient underwent a carotid
cerebral angiogram which showed no evidence of intracranial
aneurysm or arteriovenous malformation.  The impression from
this angiogram on [**10-13**] was a normal cerebral angiogram,
six vessels without evidence of aneurysm or arteriovenous
malformation.

On hospital day two, the patient received a magnetic
resonance imaging/magnetic resonance angiography of the
cervical spine which was within normal limits.  The patient
remained stable with no changes on her neurologic examination
in the Surgical Intensive Care Unit.

On hospital day three, she was transferred to the floor where
she continued to do well.  Her examination remained
unchanged.  On hospital day six, her carotid cerebral
angiogram was repeated.  This follow-up angiogram was also
negative, showing no evidence of cerebral aneurysm or
arteriovenous malformation.  The patient was discharged in
stable condition on hospital day seven.

DISCHARGE STATUS:  The patient's discharge status was to
home.

CONDITION AT DISCHARGE:  Condition on discharge was
neurologically stable.

FINAL DISCHARGE DIAGNOSES:  Headache with no aneurysm and a
subarachnoid hemorrhage.

SURGICAL/DIAGNOSTIC PROCEDURES: Diagnostic cerebral angiogram
times two.

DISCHARGE INSTRUCTIONS/FOLLOWUP:
1.  The patient was instructed to return to the hospital if
she developed a worsening headache not relieved by
medications.
2.  The patient was instructed not to lift greater than 10
pounds.
3.  The patient was instructed to follow up with her primary
care physician.
4.  The patient was also instructed to follow up with Dr.
[**First Name8 (NamePattern2) **] [**Name (STitle) 1132**] one month from discharge.

MEDICATIONS ON DISCHARGE:
1.  Decadron taper; the patient was given specific
instructions for how to take this medication over seven days.
2.  Percocet by mouth as needed (for pain).






                          [**Name6 (MD) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 1133**]

Dictated By:[**Name8 (MD) 9547**]

MEDQUIST36

D:  [**2117-11-18**]  12:53
T:  [**2117-11-20**]  08:56
JOB#:  [**Job Number 9548**]
{'Subarachnoid hemorrhage'}


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: The patient presented to the Emergency
Department with the worst headache of her life.

PRESENT ILLNESS: The patient is a 29-year-old
female who was previously healthy who presented with the
worst headache of her life starting at 12:30 p.m. on the day
of admission while running on a treadmill.  The headache was
sudden in onset with associated neck stiffness and
photophobia.  The patient experienced nausea and vomiting and
bilateral lower extremity weakness.  Her gait remained
intact.  She denied numbness or tingling.  She denied loss of
consciousness, and she denied any trauma to the head or the
rest of her body.  She denied upper extremity weakness.  The
patient is a nonsmoker with no family history of subarachnoid
or any other head bleeds.

MEDICAL HISTORY: None.

MEDICATION ON ADMISSION: Diflucan as needed.

ALLERGIES: ASPIRIN.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Subarachnoid hemorrhage'}
