CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is an 85-year-old
woman recently discharged from [**Hospital1 188**] after sustaining subdural and subarachnoid secondary
to fall from a wheel chair, which was managed non-operatively
as per the family wishes.  She was discharged in stable
condition to home, but at home was noted to have increasing
lethargy and some decreased movement, as well as increased
somnolence over the 2 days prior to admission.  She was seen
at an outside hospital, underwent an MRI, which showed a
worsening subdural hematoma and she was transferred to this
facility for further management.

MEDICAL HISTORY: Remarkable for hypertension; a left
stroke in [**2113**], seizure history, diabetes, dementia, and
right subdural hematoma.

MEDICATION ON ADMISSION: 1. Dilantin.
2. Lansoprazole.
3. Lopressor.
4. Norvasc.
5. Colace.
6. Iron.
7. Lisinopril.
8. Sliding scale insulin.

ALLERGIES: She has no known drug 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,Other left bundle branch block,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other persistent mental disorders due to conditions classified elsewhere
Traumatic subdural hem,Convulsions NEC,Fall from wheelchair,Left bb block NEC,Hypertension NOS,DMII wo cmp nt st uncntr,Mental disor NEC oth dis
Admission Date: [**2115-10-23**]        Discharge Date: [**2115-10-28**]


Service:  NSU


HISTORY OF PRESENT ILLNESS:  The patient is an 85-year-old
woman recently discharged from [**Hospital1 188**] after sustaining subdural and subarachnoid secondary
to fall from a wheel chair, which was managed non-operatively
as per the family wishes.  She was discharged in stable
condition to home, but at home was noted to have increasing
lethargy and some decreased movement, as well as increased
somnolence over the 2 days prior to admission.  She was seen
at an outside hospital, underwent an MRI, which showed a
worsening subdural hematoma and she was transferred to this
facility for further management.

PAST MEDICAL HISTORY:  Remarkable for hypertension; a left
stroke in [**2113**], seizure history, diabetes, dementia, and
right subdural hematoma.

PAST SURGICAL HISTORY:  Remarkable for placement of a PEG.

MEDICATIONS ON ADMISSION:
1. Dilantin.
2. Lansoprazole.
3. Lopressor.
4. Norvasc.
5. Colace.
6. Iron.
7. Lisinopril.
8. Sliding scale insulin.


ALLERGIES:  She has no known drug allergies.

PHYSICAL EXAMINATION:  Temperature was 97.9 degrees, heart
rate was 67, blood pressure was 137/56, respiratory rate was
10, O2 saturation was 97 percent on room air.  She was in no
apparent distress, responsive to stimuli.  Pupils were 3 mm
bilaterally.  Carotids were 2 plus without bruits.  Lungs
were clear to auscultation bilaterally except for a decreased
breath sounds at the bases.  Heart showed regular rate and
rhythm.  Abdomen was soft, minimally distended, bowel sounds
positive.  Extremities showed no clubbing, cyanosis or edema.
They were warm.

HOSPITAL COURSE:  The patient was admitted to the hospital
for frequent neurological assessment.  She was brought to the
operating room where she underwent a right frontal and
parietal burr hole and craniotomy with the evacuation of
subdural hematoma as well as placement of subdural drain.
She tolerated this procedure well and was transferred to the
intensive care unit for a close monitoring postoperatively.
On the first postoperative day, the patient was found to have
split T-wave on monitor.  She was intubated at that time and
unable to complain of pain.  She was given some doses of
Lopressor and a nitro drip was started.  A cardiology consult
was obtained who felt that this was most likely an old
arrhythmia and consistent with a left bundle-branch block
with conduction delay.  She was monitored with cardiac
enzymes and she did rule out times 3 for an MI.  Her
neurological status improved postoperatively.  She was
extubated and tolerated this well.  She was awake and alert.
She withdrew to pain and moved all 4 extremities.  She did
have her baseline hemiparesis.  Her subdural drain had
minimal output and was discontinued on [**2115-10-25**].  She had a
postoperative CT after the drain removal and she did well.
She was transferred to the neuro step down unit.  She was
seen by both Occupational Therapy and Physical Therapy and
did well.

DISPOSITION:  She was discharged to home today [**2115-10-28**].

FOLLOW UP:  She is scheduled to followup with Dr. [**First Name (STitle) **] in 7 to
10 days with a repeat CT.



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

Dictated By:[**Last Name (NamePattern1) **]
MEDQUIST36
D:  [**2115-10-28**] 17:59:46
T:  [**2115-10-29**] 05:12:11
Job#:  [**Job Number 56656**]
{'Subdural hemorrhage following injury without mention of open intracranial wound, unspecified state of consciousness,Other convulsions,Accidental fall from wheelchair,Other left bundle branch block,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other persistent mental disorders due to conditions classified elsewhere'}


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 recently discharged from [**Hospital1 188**] after sustaining subdural and subarachnoid secondary
to fall from a wheel chair, which was managed non-operatively
as per the family wishes.  She was discharged in stable
condition to home, but at home was noted to have increasing
lethargy and some decreased movement, as well as increased
somnolence over the 2 days prior to admission.  She was seen
at an outside hospital, underwent an MRI, which showed a
worsening subdural hematoma and she was transferred to this
facility for further management.

MEDICAL HISTORY: Remarkable for hypertension; a left
stroke in [**2113**], seizure history, diabetes, dementia, and
right subdural hematoma.

MEDICATION ON ADMISSION: 1. Dilantin.
2. Lansoprazole.
3. Lopressor.
4. Norvasc.
5. Colace.
6. Iron.
7. Lisinopril.
8. Sliding scale insulin.

ALLERGIES: She has no known drug 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,Other left bundle branch block,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other persistent mental disorders due to conditions classified elsewhere'}
