CHIEF COMPLAINT: unresponsiveness

PRESENT ILLNESS: 76yo woman with history of hypertension and breast cancer
s/p mastectomy presents as a transfer from an OSH with ICH. She
was playing bingo when she lost consciousness, was helped to the
ground (no trauma). She was taken to an OSH, where she was noted
to have a right gaze deviation, R>L pupils, and left
hemiparesis.
On EMS arrival she vomited x 2. She was intubated at midnight
with paralytics and sedatives. She had a head CT showing a large
right temporoparietal hemorrhage, and was transferred to [**Hospital1 18**].

MEDICAL HISTORY: HTN
breast cancer (right breast)
left mastectomy
asthma
carpal tunnel syndrome

MEDICATION ON ADMISSION: cardizem, HCTZ, estrogen, advair, albuterol, arimidex

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS: T 96.3, HR 40, BP 221/121, RR 16, SaO2 100%/vent
Genl: intubated, sedated
HEENT: coffee ground emesis from NGT
Neck: no bruits
CV: RRR, difficult to hear over vent
Chest: vented breath sounds
Abd: soft, NTND, BS+
Ext: warm and dry

FAMILY HISTORY: not known

SOCIAL HISTORY: not known
Intracerebral hemorrhage,Compression of brain,Unspecified essential hypertension,Asthma, unspecified type, unspecified,Personal history of malignant neoplasm of breast
Intracerebral hemorrhage,Compression of brain,Hypertension NOS,Asthma NOS,Hx of breast malignancy
Admission Date:  [**2182-10-16**]              Discharge Date:   [**2182-10-17**]

Date of Birth:  [**2106-5-27**]             Sex:   F

Service: NEUROLOGY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 2518**]
Chief Complaint:
unresponsiveness


Major Surgical or Invasive Procedure:
None

History of Present Illness:
76yo woman with history of hypertension and breast cancer
s/p mastectomy presents as a transfer from an OSH with ICH. She
was playing bingo when she lost consciousness, was helped to the
ground (no trauma). She was taken to an OSH, where she was noted
to have a right gaze deviation, R>L pupils, and left
hemiparesis.
On EMS arrival she vomited x 2. She was intubated at midnight
with paralytics and sedatives. She had a head CT showing a large
right temporoparietal hemorrhage, and was transferred to [**Hospital1 18**].


Past Medical History:
HTN
breast cancer (right breast)
left mastectomy
asthma
carpal tunnel syndrome


Social History:
not known


Family History:
not known


Physical Exam:
VS: T 96.3, HR 40, BP 221/121, RR 16, SaO2 100%/vent
Genl: intubated, sedated
HEENT: coffee ground emesis from NGT
Neck: no bruits
CV: RRR, difficult to hear over vent
Chest: vented breath sounds
Abd: soft, NTND, BS+
Ext: warm and dry

Neurologic examination:
Mental status: intubated, not responsive to any commands, moves
to noxious
Cranial Nerves: Fundoscopic examination reveals blurred disc
margins bilaterally. Right pupil 5mm, L 4mm, neither reactive.
Right w/ trace corneal, left w/ brisk corneal. R>L nasal tickle.
+cough.
Motor: extends BUE to noxious, R moves significantly more (?some
purposeful) than left. Slight spontaneous movement of BLE, but
none to noxious.
Sensation: response of BUE to noxious, none in BLE.
Reflexes: 1 throughout, with 1+ in left triceps, toes mute
bilaterally.


Pertinent Results:
CT-head - non-contrast [**2182-10-16**]
IMPRESSION: Large intraparenchymal hemorrhage centered within
the right basal ganglia and thalamus with extension into the
right midbrain, pons, and frontoparietotemporal lobes concerning
for hypertensive hemorrhage. Underlying mass or vascular
malformation remain diagnostic possibilities.
There is 1.4 cm right to left midline shift and right uncal
herniation.

Brief Hospital Course:
76F with likely HTN amd right sided hemorrhage involving:
right midbrain, pons, and frontoparietotemporal lobes.

ICH score calculated:
Would have been a 5 of 6 for volume greater than 30cc, GCS 4
(two points), infratentorial involvement, and IVH.  She did not
get points for age>80.  The family was appraised of studies
which showed that patients with such a high ICH score have a
very high risk of death within 30 days. The family decided to
make the patient CMO on the second day of admission.  She was
extubated and expired shortly thereafter.

Medications on Admission:
cardizem, HCTZ, estrogen, advair, albuterol, arimidex


Discharge Medications:
-

Discharge Disposition:
Expired

Discharge Diagnosis:
expired

Discharge Condition:
expired

Discharge Instructions:
expired

Followup Instructions:
expired

                             [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 2533**]

Completed by:[**2182-10-18**]
{'Intracerebral hemorrhage,Compression of brain,Unspecified essential hypertension,Asthma, unspecified type, unspecified,Personal history of malignant neoplasm of breast'}


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: unresponsiveness

PRESENT ILLNESS: 76yo woman with history of hypertension and breast cancer
s/p mastectomy presents as a transfer from an OSH with ICH. She
was playing bingo when she lost consciousness, was helped to the
ground (no trauma). She was taken to an OSH, where she was noted
to have a right gaze deviation, R>L pupils, and left
hemiparesis.
On EMS arrival she vomited x 2. She was intubated at midnight
with paralytics and sedatives. She had a head CT showing a large
right temporoparietal hemorrhage, and was transferred to [**Hospital1 18**].

MEDICAL HISTORY: HTN
breast cancer (right breast)
left mastectomy
asthma
carpal tunnel syndrome

MEDICATION ON ADMISSION: cardizem, HCTZ, estrogen, advair, albuterol, arimidex

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS: T 96.3, HR 40, BP 221/121, RR 16, SaO2 100%/vent
Genl: intubated, sedated
HEENT: coffee ground emesis from NGT
Neck: no bruits
CV: RRR, difficult to hear over vent
Chest: vented breath sounds
Abd: soft, NTND, BS+
Ext: warm and dry

FAMILY HISTORY: not known

SOCIAL HISTORY: not known 

### Response:
{'Intracerebral hemorrhage,Compression of brain,Unspecified essential hypertension,Asthma, unspecified type, unspecified,Personal history of malignant neoplasm of breast'}
