CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is an 85-year-old
woman with baseline dementia, status post a left occipital
stroke a year ago, who presents from an outside hospital with
a large right subdural hematoma.  The patient was intubated
and sedated during initial exam.

MEDICAL HISTORY: Hypertension.

MEDICATION ON ADMISSION: 

ALLERGIES: No known allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Subdural hemorrhage following injury without mention of open intracranial wound, unspecified state of consciousness,Other convulsions,Accidental fall from wheelchair,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Personal history of other diseases of circulatory system
Traumatic subdural hem,Convulsions NEC,Fall from wheelchair,Hypertension NOS,DMII wo cmp nt st uncntr,Hx-circulatory dis NEC
Admission Date: [**2115-10-8**]        Discharge Date: [**2115-10-17**]


Service:  NSU


HISTORY OF PRESENT ILLNESS:  The patient is an 85-year-old
woman with baseline dementia, status post a left occipital
stroke a year ago, who presents from an outside hospital with
a large right subdural hematoma.  The patient was intubated
and sedated during initial exam.

ALLERGIES:  No known allergies.

MEDICATIONS:
1. Nitroglycerin 0.4.
2. Trazodone 50 q at bedtime.
3. Norvasc 5 po once daily.
4. Plavix 75 po once daily.
5. Prevacid 30 po once daily.
6. Lisinopril 20 po once daily.
7. Dilantin 15 po once daily.
8. Aspirin 81 po once daily.

CT scan shows a large right subdural hematoma and
subarachnoid with minimal midline shift.

HOSPITAL COURSE:  On initial exam, the patient withdrew to
painful stimulation in the right upper extremity, very
sluggish withdrawal to pain in the left upper extremity.  She
was admitted to the ICU with q 1 h neuro checks, and a repeat
head CT the following morning.  The patient actually fell out
of a wheelchair at home, and was being cared

DICTATION ENDED


                        [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 55481**], [**MD Number(1) 56557**]

Dictated By:[**Last Name (NamePattern1) 6583**]
MEDQUIST36
D:  [**2115-10-17**] 11:27:28
T:  [**2115-10-17**] 11:56:01
Job#:  [**Job Number 56631**]


Admission Date: [**2115-10-7**]        Discharge Date: [**2115-10-17**]


Service:


HISTORY OF PRESENT ILLNESS:  The patient is an 85-year-old
woman with baseline dementia status post a left occipital
stroke 1 year ago, presented to an outside hospital with a
large right subdural hematoma after falling out of a
wheelchair.  The patient was intubated and sedated on the
initial examination.

PAST MEDICAL HISTORY:  Hypertension.

Stroke.

Seizure disorder.

Diabetes.

EXAMINATION:  The patient, on initial examination, withdrew
to painful stimulation the right upper extremity and sluggish
withdrawal to painful stimulation in the left upper
extremity.  Pupils were equal and reactive.

The patient was admitted to the ICU for close neurologic
observation.  The patient had a C-spine clear with MRI scan.
She had repeat head CT which showed stable size of subdural
hematoma.  She, neurologically, continued to be moving all
extremities to stimulation, right greater than left, and
localizing to pain.  She was on mannitol 25 q.6h.  She had a
repeat head CT on [**2115-10-10**], which was unchanged.  She
continued on mannitol, continued to have her eyes open but
did not follow commands with a left hemiparesis, which was
baseline and withdrawal of her all 4 extremities.

On [**2115-10-12**], the patient was transferred to the Step-Down
Unit.  She continued to remain neurologically unchanged with
a stable head CT.  She was eventually transferred to the
regular floor.  She was seen by Physical Therapy and
Occupational Therapy and found to be safe for discharge home
with her family with 24-hour care from her family.  The
family cleared her for transfers with a [**Doctor Last Name 2598**] Lift.  She also
had a swallow evaluation and remained NPO with PEG in place
for feeding.  Her neurologic status remained stable, she
would localize briskly on the right.  She has a left
hemiparesis, opened eyes to commands.  She will have a head
CT on the day of discharge; if that is stable, she will be
discharged on [**2115-10-17**], with follow-up with Dr. [**First Name (STitle) **] in one
month with a repeat head CT.

MEDICATIONS ON DISCHARGE:
1. Dilantin 100 mg p.o. t.i.d.
2. Pantoprazole 40 mg p.o. q.d.
3  Ferrous sulfate 225 p.o. q.d.
1. Metoprolol 75 p.o. b.i.d.
2. Levofloxacin 250 p.o. q.4h. for 5 days for UTI.
3. Lisinopril 20 p.o. q.d.
4. Amlodipine 5 mg p.o. q.d.
5. Nystatin 5 cc p.o. q.i.d. p.r.n.
6. Heparin 5000 units subcutaneous, which will be
   discontinued.
7. Colace 100 mg p.o. b.i.d.


CONDITION ON DISCHARGE:  Stable.

FOLLOW UP:  She will follow up with Dr. [**First Name (STitle) **] in one month with
a repeat head CT at that time.



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

Dictated By:[**Last Name (NamePattern1) 6583**]
MEDQUIST36
D:  [**2115-10-17**] 11:33:08
T:  [**2115-10-17**] 22:44:32
Job#:  [**Job Number 56655**]
{'Subdural hemorrhage following injury without mention of open intracranial wound, unspecified state of consciousness,Other convulsions,Accidental fall from wheelchair,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Personal history of other diseases of circulatory system'}


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 an 85-year-old
woman with baseline dementia, status post a left occipital
stroke a year ago, who presents from an outside hospital with
a large right subdural hematoma.  The patient was intubated
and sedated during initial exam.

MEDICAL HISTORY: Hypertension.

MEDICATION ON ADMISSION: 

ALLERGIES: No known allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Subdural hemorrhage following injury without mention of open intracranial wound, unspecified state of consciousness,Other convulsions,Accidental fall from wheelchair,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Personal history of other diseases of circulatory system'}
