CHIEF COMPLAINT: Acom aneurysm

PRESENT ILLNESS: 55 y/o male who had a previous subarachnoid hemorrhage from an
Acom aneurysm which was previously coiled, but had re canulized.
He presented for recoiling and stenting of the aneurysm.

MEDICAL HISTORY: HCV- treated x 2 with ribavirin
Hep C
Subarachnoid hemorrhage
Cerebral aneurysm

MEDICATION ON ADMISSION: amlodipine and paroxetine

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Neurologically intact on Admission.

FAMILY HISTORY: Negative for intracranial hemorrhage or aneurysm. Uncle had
stroke in his 50s, father had [**Name2 (NI) **].

SOCIAL HISTORY: Works for the government as a electronic tech. Smokes, drinks
moderate EtOH, no illicits.
Cerebral aneurysm, nonruptured,Hematoma complicating a procedure,Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure
Nonrupt cerebral aneurym,Hematoma complic proc,Hx TIA/stroke w/o resid,Abn react-procedure NEC
Name:  [**Known lastname 9929**],[**Known firstname 116**]                     Unit No:   [**Numeric Identifier 14187**]

Admission Date:  [**2125-5-16**]              Discharge Date:   [**2125-5-18**]

Date of Birth:  [**2069-9-7**]             Sex:   M

Service: NEUROSURGERY

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 40**]
Addendum:
The patient was evalauted prior to discharge on [**5-17**] and it was
determined that it would be best for him to stay for another
evening while awaiting bowel movement and for his family to
prepare for [**Last Name (un) **] discharge to home. On the morning of [**5-18**] he was
seen and evaluated asnd it was determined that he was fit for
discharge.

Discharge Disposition:
Home

                             [**Name6 (MD) **] [**Last Name (NamePattern4) 43**] MD [**MD Number(2) 44**]

Completed by:[**2125-5-18**]

Admission Date:  [**2125-5-16**]              Discharge Date:   [**2125-5-18**]

Date of Birth:  [**2069-9-7**]             Sex:   M

Service: NEUROSURGERY

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 78**]
Chief Complaint:
Acom aneurysm

Major Surgical or Invasive Procedure:
Stenting and coiling of Acom aneurysm


History of Present Illness:
55 y/o male who had a previous subarachnoid hemorrhage from an
Acom aneurysm which was previously coiled, but had re canulized.
He presented for recoiling and stenting of the aneurysm.

Past Medical History:
HCV- treated x 2 with ribavirin
Hep C
Subarachnoid hemorrhage
Cerebral aneurysm

Social History:
Works for the government as a electronic tech. Smokes, drinks
moderate EtOH, no illicits.


Family History:
Negative for intracranial hemorrhage or aneurysm. Uncle had
stroke in his 50s, father had [**Name2 (NI) **].


Physical Exam:
Neurologically intact on Admission.

On discharge: intact

Pertinent Results:
[**5-17**] left femoral US
Tiny left groin hematoma; however, no pseudoaneurysm or AV
fistula is visualized.


Brief Hospital Course:
Mr. [**Known lastname 23657**] presented to the hospital for elective re coiling and
stenting of a previously ruptured Acom aneurysm.

He was takent to the Angio suite and intubated by Anesthesia and
underwent the procedure without complications. Patient remained
in the PACU until ICU bed was available. He was placed on a
heparin gtt with goal PTT 60-80. Post angio check, bilateral
pulses were 2+ and patient was full strength. A hematoma was
seen at L groin. Pressure was held at site for 25 minutes and
pressure dressing placed.

On [**5-17**], patient's exam remains intact. Left groin with stable
hematoma, but soft to touch. Dorsalis pedis pulses are palpable
bilaterally. Heparin gtt was discontinued and diet was advanced.
A groin ultrasound was ordered to evaluate vessel for further
injury which showed a small groin hematoma but no other signs of
pseudoaneurysm

Medications on Admission:
amlodipine and paroxetine

Discharge Medications:
1. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily)
for 29 days.
Disp:*29 Tablet(s)* Refills:*0*
2. amlodipine 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).

3. oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4
hours) as needed for pain.
Disp:*30 Tablet(s)* Refills:*0*
4. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
5. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*0*
6. paroxetine HCl 12.5 mg Tablet Extended Release 24 hr Sig: One
(1) Tablet Extended Release 24 hr PO once a day.


Discharge Disposition:
Home

Discharge Diagnosis:
Acom aneurysm
L groin hematoma


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.


Discharge Instructions:
Angiogram with Embolization and/or Stent placement
Medications:
??????	Take Aspirin 325mg (enteric coated) once daily.
??????	Take Plavix (Clopidogrel) 75mg once daily for month.
??????	Continue all other medications you were taking before surgery,
unless otherwise directed
??????	You make take Tylenol or prescribed pain medications for any
post procedure pain or discomfort.

What activities you can and cannot do:
??????	When you go home, you may walk and go up and down stairs.
??????	You may shower (let the soapy water run over groin incision,
rinse and pat dry)
??????	Your incision may be left uncovered, unless you have small
amounts of drainage from the wound, then place a dry dressing or
band aid over the area that is draining, as needed
??????	No heavy lifting, pushing or pulling (greater than 5 lbs) for
1 week (to allow groin puncture to heal).
??????	After 1 week, you may resume sexual activity.
??????	After 1 week, gradually increase your activities and distance
walked as you can tolerate.
??????	No driving until you are no longer taking pain medications

What to report to office:
??????	Changes in vision (loss of vision, blurring, double vision,
half vision)
??????	Slurring of speech or difficulty finding correct words to use
??????	Severe headache or worsening headache not controlled by pain
medication
??????	A sudden change in the ability to move or use your arm or leg
or the ability to feel your arm or leg
??????	Trouble swallowing, breathing, or talking
??????	Numbness, coldness or pain in lower extremities
??????	Temperature greater than 101.5F for 24 hours
??????	New or increased drainage from incision or white, yellow or
green drainage from incisions
??????	Bleeding from groin puncture site

*SUDDEN, SEVERE BLEEDING OR SWELLING
(Groin puncture site)
Lie down, keep leg straight and have someone apply firm pressure
to area for 10 minutes. If bleeding stops, call our office. If
bleeding does not stop, call 911 for transfer to closest
Emergency Room!


Followup Instructions:
Please follow up with Dr. [**First Name (STitle) **] in one month with an MRI/MRA.
Call [**Telephone/Fax (1) 4296**] for an appointment



Completed by:[**2125-5-17**]
{'Cerebral aneurysm, nonruptured,Hematoma complicating a procedure,Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure'}


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: Acom aneurysm

PRESENT ILLNESS: 55 y/o male who had a previous subarachnoid hemorrhage from an
Acom aneurysm which was previously coiled, but had re canulized.
He presented for recoiling and stenting of the aneurysm.

MEDICAL HISTORY: HCV- treated x 2 with ribavirin
Hep C
Subarachnoid hemorrhage
Cerebral aneurysm

MEDICATION ON ADMISSION: amlodipine and paroxetine

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Neurologically intact on Admission.

FAMILY HISTORY: Negative for intracranial hemorrhage or aneurysm. Uncle had
stroke in his 50s, father had [**Name2 (NI) **].

SOCIAL HISTORY: Works for the government as a electronic tech. Smokes, drinks
moderate EtOH, no illicits. 

### Response:
{'Cerebral aneurysm, nonruptured,Hematoma complicating a procedure,Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure'}
