CHIEF COMPLAINT: recanalization of aneurysm

PRESENT ILLNESS: 54yo gentleman who presented [**2124-5-8**] after suffering from a
headache for 6 days. He was found to have a ruptured AComm
Artery aneurysm which was subsequently coiled. His hospital stay
was complicated by vasospasm. Recent repeat imaging revealed
recanalization of the aneurysm and the patient returns for
angiogram with possible coiling.

MEDICAL HISTORY: HCV- treated x 2 with ribavirin

MEDICATION ON ADMISSION: restoril
zoloft

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Awake alert oriented x 3 / CN II-XII intact / non focal exam.

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
rare EtOH, no illicits.
Cerebral aneurysm, nonruptured,Thrombocytopenia, unspecified,Chronic hepatitis C without mention of hepatic coma
Nonrupt cerebral aneurym,Thrombocytopenia NOS,Chrnc hpt C wo hpat coma
Admission Date:  [**2124-7-3**]              Discharge Date:   [**2124-7-4**]

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

Service: NEUROSURGERY

Allergies:
No Known Allergies / Adverse Drug Reactions

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

Major Surgical or Invasive Procedure:
[**2124-7-3**]: Cerebral Angiogram


History of Present Illness:
54yo gentleman who presented [**2124-5-8**] after suffering from a
headache for 6 days. He was found to have a ruptured AComm
Artery aneurysm which was subsequently coiled. His hospital stay
was complicated by vasospasm. Recent repeat imaging revealed
recanalization of the aneurysm and the patient returns for
angiogram with possible coiling.

Past Medical History:
HCV- treated x 2 with ribavirin


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


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


Physical Exam:
Awake alert oriented x 3 / CN II-XII intact / non focal exam.

Groin site intact s/p angiogram.

Pertinent Results:
[**2124-7-4**] 04:10AM BLOOD WBC-4.3 RBC-4.16* Hgb-14.7 Hct-41.6
MCV-100* MCH-35.4* MCHC-35.4* RDW-15.1 Plt Ct-68*
[**2124-7-3**] 02:20PM BLOOD WBC-3.6* RBC-4.36* Hgb-15.4 Hct-43.4
MCV-100* MCH-35.4* MCHC-35.5* RDW-14.8 Plt Ct-71*
[**2124-7-4**] 04:10AM BLOOD Plt Ct-68*
[**2124-7-3**] 11:32PM BLOOD PT-16.8* PTT-54.9* INR(PT)-1.5*
[**2124-7-3**] 02:20PM BLOOD Plt Smr-VERY LOW Plt Ct-71*
[**2124-7-3**] 02:20PM BLOOD PT-16.2* PTT-31.0 INR(PT)-1.4*
[**2124-7-4**] 04:10AM BLOOD Glucose-90 UreaN-9 Creat-0.6 Na-143
K-3.2* Cl-111* HCO3-26 AnGap-9
[**2124-7-3**] 02:20PM BLOOD Glucose-94 UreaN-10 Creat-0.6 Na-142
K-2.9* Cl-109* HCO3-24 AnGap-12
[**2124-7-4**] 04:10AM BLOOD Calcium-7.8* Phos-4.2# Mg-1.9
[**2124-7-3**] 02:20PM BLOOD Calcium-8.3* Phos-2.2*

[**2124-7-3**]  cerebral angiogram results pending at the time of this
discharge

Brief Hospital Course:
Pt electively presents and underwent a cerebral angiogram
without event.  he was maintained on a heparin gtt overnight in
the ICU.  This was discontinued in the am.  His exam was non
focal.  He did have two lab results with plt counts of 71 and
68.  This was seen on prior values from [**Month (only) 958**] and [**Month (only) 547**] of this
yr.  This signer of the summary spoke with the PCP about the
same.  She will see the pt in the office this week and discuss
these results. She did not want any additional lab values at
this time. He will be discharged to home from the ICU and he
agrees with this plan.

Medications on Admission:
restoril
zoloft

Discharge Medications:
1. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
[**Month (only) **]:*30 Tablet(s)* Refills:*2*
2. oxycodone-acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4H (every 4 hours) as needed for pain: do not drive while on
this medication.
[**Month (only) **]:*20 Tablet(s)* Refills:*0*
3. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
[**Month (only) **]:*60 Capsule(s)* Refills:*2*
4. sertraline 50 mg Tablet Sig: Two (2) Tablet PO HS (at
bedtime).
5. temazepam 15 mg Capsule Sig: [**2-13**] Capsule PO HS (at bedtime).



Discharge Disposition:
Home

Discharge Diagnosis:
-Recanalization of Anterior communicating artery aneurysm
-Thrombocytopenia


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.
??????	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


Followup Instructions:
Please call [**Telephone/Fax (1) 1669**] to make a follow up appointment with
Dr. [**First Name (STitle) **]. You will need to be seen in 3 months with and MRI/
MRA with Dr. [**First Name (STitle) **] protocol.

Your platelet count was as low as 68 during your hospital stay.
This was discussed with your primary care physician [**Last Name (NamePattern4) **]. [**Last Name (STitle) **].
You are due to see Dr. [**Last Name (STitle) **] this Friday according to their
office staff.  Please call [**Telephone/Fax (1) **] to confirm this - your
doctor will discuss your workup of this with you on your
appointment.  She does not want you to have any additional lab
tests at this time.



Completed by:[**2124-7-4**]
{'Cerebral aneurysm, nonruptured,Thrombocytopenia, unspecified,Chronic hepatitis C without mention of hepatic coma'}


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: recanalization of aneurysm

PRESENT ILLNESS: 54yo gentleman who presented [**2124-5-8**] after suffering from a
headache for 6 days. He was found to have a ruptured AComm
Artery aneurysm which was subsequently coiled. His hospital stay
was complicated by vasospasm. Recent repeat imaging revealed
recanalization of the aneurysm and the patient returns for
angiogram with possible coiling.

MEDICAL HISTORY: HCV- treated x 2 with ribavirin

MEDICATION ON ADMISSION: restoril
zoloft

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Awake alert oriented x 3 / CN II-XII intact / non focal exam.

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
rare EtOH, no illicits. 

### Response:
{'Cerebral aneurysm, nonruptured,Thrombocytopenia, unspecified,Chronic hepatitis C without mention of hepatic coma'}
