CHIEF COMPLAINT: This 67-year-old woman developed difficulty with balance and a
whooshing sound on the left side late 12/[**2153**]. CT scan showed
left sphenoid [**Doctor First Name 362**] mass.  The patient's MRI done at [**Hospital1 18**] on
[**2154-1-29**] showed a large extradural mass along the planum
sphenoidale, which reportedly encased the prechiasmatic left
optic nerve and abutted the left side of the chiasm.  The
patient
has been booked for surgery in two days.

PRESENT ILLNESS: This 67-year-old woman developed difficulty with balance and a
whooshing sound on the left side late 12/[**2153**]. CT scan showed
left sphenoid [**Doctor First Name 362**] mass.  The patient's MRI done at [**Hospital1 18**] on
[**2154-1-29**] showed a large extradural mass along the planum
sphenoidale, which reportedly encased the prechiasmatic left
optic nerve and abutted the left side of the chiasm.  The
patient
has been booked for surgery in two days.

MEDICAL HISTORY: No significant PMH

MEDICATION ON ADMISSION: Valium

ALLERGIES: Lipitor / Percodan

PHYSICAL EXAM: O: T: 97.8   BP: 190/101   HR: 114    R 20    O2Sats 100%
Gen: WD/WN, comfortable, NAD.
HEENT: normocephalic
Extrem: Warm and well-perfused.

FAMILY HISTORY: noncontributory

SOCIAL HISTORY: Married with 2 sons (age 36, 32). Occasional
alcohol use. Denies tobacco use.  She is retired (previously
worked as receptionist in Radiology at [**Location (un) 745**]-Wellesly and at
CHB).
Benign neoplasm of cerebral meninges,Compression of brain,Unspecified essential hypertension,Nontoxic uninodular goiter
Ben neo cerebr meninges,Compression of brain,Hypertension NOS,Nontox uninodular goiter
Name:  [**Known lastname 3205**],[**Known firstname **]                  Unit No:   [**Numeric Identifier 10741**]

Admission Date:  [**2154-2-20**]              Discharge Date:   [**2154-2-26**]

Date of Birth:  [**2086-5-5**]             Sex:   F

Service: NEUROSURGERY

Allergies:
Lipitor / Percodan

Attending:[**First Name3 (LF) 599**]
Addendum:
Please note in the patient's diagnosis list, the following
diagnosis was omitted:
Brain Compression for a sphenoid [**Doctor First Name **] meningioma.

Discharge Disposition:
Extended Care

Facility:
[**Hospital6 609**] for the Aged - MACU

                             [**Name6 (MD) **] [**Last Name (NamePattern4) 603**] MD [**MD Number(2) 604**]

Completed by:[**2154-4-8**]

Admission Date:  [**2154-2-20**]              Discharge Date:   [**2154-2-26**]

Date of Birth:  [**2086-5-5**]             Sex:   F

Service: NEUROSURGERY

Allergies:
Lipitor / Percodan

Attending:[**First Name3 (LF) 1835**]
Chief Complaint:
This 67-year-old woman developed difficulty with balance and a
whooshing sound on the left side late 12/[**2153**]. CT scan showed
left sphenoid [**Doctor First Name 362**] mass.  The patient's MRI done at [**Hospital1 18**] on
[**2154-1-29**] showed a large extradural mass along the planum
sphenoidale, which reportedly encased the prechiasmatic left
optic nerve and abutted the left side of the chiasm.  The
patient
has been booked for surgery in two days.

As far as visual symptoms go, she was told that the left eye was
a lazy eye decades ago.  She had not noticed any change in her
vision in that eye, as she has always had better vision in her
right eye.


Major Surgical or Invasive Procedure:
Left sided craniotomy for resection of sphenoid [**Doctor First Name 362**] meningeoma

History of Present Illness:
This 67-year-old woman developed difficulty with balance and a
whooshing sound on the left side late 12/[**2153**]. CT scan showed
left sphenoid [**Doctor First Name 362**] mass.  The patient's MRI done at [**Hospital1 18**] on
[**2154-1-29**] showed a large extradural mass along the planum
sphenoidale, which reportedly encased the prechiasmatic left
optic nerve and abutted the left side of the chiasm.  The
patient
has been booked for surgery in two days.

As far as visual symptoms go, she was told that the left eye was
a lazy eye decades ago.  She had not noticed any change in her
vision in that eye, as she has always had better vision in her
right eye.


Past Medical History:
No significant PMH

Social History:
Married with 2 sons (age 36, 32). Occasional
alcohol use. Denies tobacco use.  She is retired (previously
worked as receptionist in Radiology at [**Location (un) 745**]-Wellesly and at
CHB).

Family History:
noncontributory

Physical Exam:
O: T: 97.8   BP: 190/101   HR: 114    R 20    O2Sats 100%
Gen: WD/WN, comfortable, NAD.
HEENT: normocephalic
Extrem: Warm and well-perfused.

Neuro:
Mental status: Awake and alert, cooperative with exam, normal
affect.
Orientation: Oriented to person, place, and date.
Recall: able to name president. able to name pen/light
Language: Speech fluent with good comprehension and repetition.
Naming intact. No dysarthria or paraphasic errors.

Cranial Nerves:
I: Not tested
II: Pupils equally round and reactive to light,  4 to 2
mm bilaterally. Visual fields are full to confrontation.
III, IV, VI: Extraocular movements intact bilaterally without
nystagmus.
V, VII: Facial strength and sensation intact and symmetric with
[**Initials (NamePattern4) **] [**Last Name (un) **]-labial flattening that is baseline per patient.
VIII: Hearing intact to voice.
IX, X: Palatal elevation symmetrical.
[**Doctor First Name 81**]: Sternocleidomastoid and trapezius normal bilaterally.
XII: Tongue midline without fasciculations.

Motor: Normal bulk and tone bilaterally. No abnormal movements,
tremors. Strength full power [**5-30**] throughout. No pronator drift

Sensation: Intact to light touch

Coordination: normal on finger-nose-finger, rapid alternating
movements

DISCHARGE EXAM:
As above. Neurologically intact, incision clean, dry and intact

Pertinent Results:
MRI HEAD
Redemonstration of the known inferior frontal region/planum
sphenoidal
dural-based mass lesion, measuring approximately 2.7 x 1.5 x 2.8
cm, extending into the region of the optic nerves and the
cavernous sinuses for surgical planning. Please see the prior MR
study for additional details

CT HEad [**2-21**]:
Postoperative changes without acute intracranial hemorrhage. TO
correlate with surgical details. There is 5 mm of rightward
midline shift
anteriorly and pneumocephalus

MRI Head [**2-21**]:
IMPRESSION:
1. Post-surgical changes in the left frontal region and at the
skull base,
with an extra-axial fluid collection in the left frontal region,
with mild
displacement of the left cerebral hemisphere. This can be better
assessed on the followup on the CT study. Small-to-moderate
amount of pneumocephalus, right more than left, with
displacement of the right frontal lobe.

2. Two small areas of decreased diffusion in the left frontal
lobe laterally at the periphery which may represent areas of
acute infarction/related to blood products. Attention on
followup. Small amount of fluid/mucosal thickening in the left
mastoid air cells. No obvious evidence of nodular enhancing
tissue noted in the surgical resection site to suggest obvious
residual tumor. However, consider followup for better
assessment.


Brief Hospital Course:
Ms. [**Known lastname **] was admitted to [**Hospital1 18**] to undergo elective resection
of a left sided sphenoid [**Doctor First Name 362**] meningeoma. Operative course was
uncomplicated. Post operatively she was transferred to the ICU.
The endocrine service was called  to follow this patient in the
hospital given that they had seen her pre operatively and
considerable involvement of the pituitary stalk put her at risk
for development of DI.
On [**2-21**] she remained in the ICU and was observed for potential
complications secondary to any endocrine dysfunction she may
have acquired during surgery. Also an MRI was completed and a
decadron taper initiated. her lab values remained within normal
limits and on 1.28 she was deemed fit for transfer to the
stepdown unit. The patient made steady progress was transferred
to the floor but found need acute rehab from PT/OT, particulary
with executive functioning.


Medications on Admission:
Valium

Discharge Medications:
1. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
2. senna 8.6 mg Tablet Sig: One (1) Tablet PO HS (at bedtime).
3. heparin (porcine) 5,000 unit/mL Solution Sig: One (1)
Injection TID (3 times a day).
4. dexamethasone 2 mg Tablet Sig: One (1) Tablet PO q12 ().
5. phenytoin 50 mg Tablet, Chewable Sig: Two (2) Tablet,
Chewable PO TID (3 times a day).
6. ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
7. hydrocodone-acetaminophen 5-500 mg Tablet Sig: 1-2 Tablets PO
Q4H (every 4 hours) as needed for Pain.


Discharge Disposition:
Extended Care

Facility:
[**Hospital6 459**] for the Aged - MACU

Discharge Diagnosis:
sphenoid [**Doctor First Name 362**] meningioma


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


Discharge Instructions:
??????	Have a friend/family member check your incision daily for
signs of infection.
??????	Take your pain medicine as prescribed.
??????	Exercise should be limited to walking; no lifting, straining,
or excessive bending.
??????	You may wash your hair only after sutures and/or staples have
been removed. If your wound closure uses dissolvable sutures,
you must keep that area dry for 10 days.
??????	You may shower before this time using a shower cap to cover
your head.
??????	Increase your intake of fluids and fiber, as narcotic pain
medicine can cause constipation. We generally recommend taking
an over the counter stool softener, such as Docusate (Colace)
while taking narcotic pain medication.
??????	Unless directed by your doctor, do not take any
anti-inflammatory medicines such as Motrin, Aspirin, Advil, and
Ibuprofen etc.
??????	If you have been prescribed Dilantin (Phenytoin) for
anti-seizure medicine, take it as prescribed and follow up with
laboratory blood drawing in one week.  This can be drawn at your
PCP??????s office, but please have the results faxed to [**Telephone/Fax (1) 87**].
If you have been discharged on Keppra (Levetiracetam), you will
not require blood work monitoring.
??????	If you are being sent home on steroid medication, make sure
you are taking a medication to protect your stomach (Prilosec,
Protonix, or Pepcid), as these medications can cause stomach
irritation.  Make sure to take your steroid medication with
meals, or a glass of milk.
??????	Clearance to drive and return to work will be addressed at
your post-operative office visit.
??????	Make sure to continue to use your incentive spirometer while
at home.


Followup Instructions:
??????Please return to the office in [**8-4**] days (from your date of
surgery) for removal of your staples/sutures and/or a wound
check. This appointment can be made with the Nurse Practitioner.
 Please make this appointment by calling [**Telephone/Fax (1) 1669**]. If you
live quite a distance from our office, please make arrangements
for the same, with your PCP.
??????You have an appointment in the Brain [**Hospital 341**] Clinic on [**3-25**] at
9:30 am.  The Brain [**Hospital 341**] Clinic is located on the [**Hospital Ward Name 516**]
of [**Hospital1 18**], in the [**Hospital Ward Name 23**] Building, [**Location (un) **]. Their phone number
is [**Telephone/Fax (1) 1844**]. Please call if you need to change your
appointment, or require additional directions.
??????You will not need an MRI of the brain



Completed by:[**2154-2-26**]
{'Benign neoplasm of cerebral meninges,Compression of brain,Unspecified essential hypertension,Nontoxic uninodular goiter'}


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: This 67-year-old woman developed difficulty with balance and a
whooshing sound on the left side late 12/[**2153**]. CT scan showed
left sphenoid [**Doctor First Name 362**] mass.  The patient's MRI done at [**Hospital1 18**] on
[**2154-1-29**] showed a large extradural mass along the planum
sphenoidale, which reportedly encased the prechiasmatic left
optic nerve and abutted the left side of the chiasm.  The
patient
has been booked for surgery in two days.

PRESENT ILLNESS: This 67-year-old woman developed difficulty with balance and a
whooshing sound on the left side late 12/[**2153**]. CT scan showed
left sphenoid [**Doctor First Name 362**] mass.  The patient's MRI done at [**Hospital1 18**] on
[**2154-1-29**] showed a large extradural mass along the planum
sphenoidale, which reportedly encased the prechiasmatic left
optic nerve and abutted the left side of the chiasm.  The
patient
has been booked for surgery in two days.

MEDICAL HISTORY: No significant PMH

MEDICATION ON ADMISSION: Valium

ALLERGIES: Lipitor / Percodan

PHYSICAL EXAM: O: T: 97.8   BP: 190/101   HR: 114    R 20    O2Sats 100%
Gen: WD/WN, comfortable, NAD.
HEENT: normocephalic
Extrem: Warm and well-perfused.

FAMILY HISTORY: noncontributory

SOCIAL HISTORY: Married with 2 sons (age 36, 32). Occasional
alcohol use. Denies tobacco use.  She is retired (previously
worked as receptionist in Radiology at [**Location (un) 745**]-Wellesly and at
CHB). 

### Response:
{'Benign neoplasm of cerebral meninges,Compression of brain,Unspecified essential hypertension,Nontoxic uninodular goiter'}
