CHIEF COMPLAINT: aneurysm

PRESENT ILLNESS: 49-year-old woman with a history of headache.  [**Known firstname 1356**] is a
pleasant neuro ICU nurse who struck her head while at work in
[**2140-6-29**].  She had no loss of consciousness, but developed
persistent occipital headaches.  Two weeks post injury, her
headaches continued and she developed nausea.  She denied any
visual disturbances or weakness or numbness to her extremities.
She reported to work and a CT scan was done with negative
results. Symptoms continued
and she complained of a "sharp stabbing pain" to her occipital
area .  An MRI was done and an AComm aneurysm reported. An
angiogram was performed revealing an Acomm artery aneurysm, SCA
aneurysm and Cavernous carotid aneurysm. On [**2140-9-19**] she
underwent successful coiling of the acomm artery aneurysm. She
then underwent subsequent clipping of her SCA aneurysm at [**Hospital1 2025**].
On [**5-31**] she underwent stenting of her left ICA aneurysm and she
returns today for subsequent coil embolization.

MEDICAL HISTORY: Acomm artery aneurysm s/p coiling
SCA aneurysm s/p craniotomy and clipping

MEDICATION ON ADMISSION: none

ALLERGIES: Dicloxacillin

PHYSICAL EXAM: On Admission:
nonfocal
AOx3, following commands
CN II-XII intact
Motor: 5/5 strength x 4 extremities
Sensation intact to light touch

FAMILY HISTORY: non contributory

SOCIAL HISTORY: Married, three children age 16, 17 and 20. Works as an ICU
nurse @ [**Hospital1 18**].  Previously smoked, quit six years ago. 2-3drinks
week.
Cerebral aneurysm, nonruptured,Personal history of tobacco use
Nonrupt cerebral aneurym,History of tobacco use
Admission Date:  [**2141-10-4**]              Discharge Date:   [**2141-10-5**]

Date of Birth:  [**2092-2-13**]             Sex:   F

Service: NEUROSURGERY

Allergies:
Dicloxacillin

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

Major Surgical or Invasive Procedure:
[**2141-10-4**]: cerebral angiogram, coiling of Left ICA aneurysm


History of Present Illness:
49-year-old woman with a history of headache.  [**Known firstname 1356**] is a
pleasant neuro ICU nurse who struck her head while at work in
[**2140-6-29**].  She had no loss of consciousness, but developed
persistent occipital headaches.  Two weeks post injury, her
headaches continued and she developed nausea.  She denied any
visual disturbances or weakness or numbness to her extremities.
She reported to work and a CT scan was done with negative
results. Symptoms continued
and she complained of a "sharp stabbing pain" to her occipital
area .  An MRI was done and an AComm aneurysm reported. An
angiogram was performed revealing an Acomm artery aneurysm, SCA
aneurysm and Cavernous carotid aneurysm. On [**2140-9-19**] she
underwent successful coiling of the acomm artery aneurysm. She
then underwent subsequent clipping of her SCA aneurysm at [**Hospital1 2025**].
On [**5-31**] she underwent stenting of her left ICA aneurysm and she
returns today for subsequent coil embolization.


Past Medical History:
Acomm artery aneurysm s/p coiling
SCA aneurysm s/p craniotomy and clipping

Social History:
 Married, three children age 16, 17 and 20. Works as an ICU
nurse @ [**Hospital1 18**].  Previously smoked, quit six years ago. 2-3drinks
week.


Family History:
non contributory

Physical Exam:
On Admission:
nonfocal
AOx3, following commands
CN II-XII intact
Motor: 5/5 strength x 4 extremities
Sensation intact to light touch

On discharge:
Intact and stable
Groin c/d/i, no hematoma

Pertinent Results:
[**2141-10-4**] 12:54PM   WBC-3.1* RBC-4.07* HGB-11.7* HCT-35.8* MCV-88
MCH-28.7 MCHC-32.7 RDW-14.0
[**2141-10-4**] 12:54PM   PLT COUNT-243
[**2141-10-4**] 12:54PM   PT-11.8 PTT-150* INR(PT)-1.1
[**2141-10-4**] 09:00AM   CREAT-0.6
[**2141-10-4**] 09:00AM   PT-10.8 PTT-30.4 INR(PT)-1.0

Brief Hospital Course:
Pt electively presented and underwent a cerebral angiogram and
coiling. Procedure was without complication and she tolerated it
well. She was extubated and transferred to the SICU for close
neurological observation. At 1500 her right femoral sheath was
removed and direct manual pressure was held for 25 minutes. She
was kept on bedrest x 6hours.  She was started on Aspirin 325mg
and will continue this dose daily x1 year.

She remained neurologically stable overnight and was cleared for
discharge home in the AM of [**10-5**].

Medications on Admission:
none

Discharge Medications:
1. Acetaminophen 325-650 mg PO Q6H:PRN pain
2. Aspirin 325 mg PO DAILY
RX *aspirin 325 mg 1 tablet(s) by mouth Daily Disp #*30 Tablet
Refills:*6


Discharge Disposition:
Home

Discharge Diagnosis:
left ICA aneurysm

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
Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) **]
Medications:
??????	Take Aspirin 325mg (enteric coated) once daily for 1 year.

??????	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:
Follow up in 6 months with an MRI/A brain and follow up in
clinic.  Call [**Telephone/Fax (1) 1669**] to schedule.


Completed by:[**2141-10-5**]
{'Cerebral aneurysm, nonruptured,Personal history of tobacco use'}


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: aneurysm

PRESENT ILLNESS: 49-year-old woman with a history of headache.  [**Known firstname 1356**] is a
pleasant neuro ICU nurse who struck her head while at work in
[**2140-6-29**].  She had no loss of consciousness, but developed
persistent occipital headaches.  Two weeks post injury, her
headaches continued and she developed nausea.  She denied any
visual disturbances or weakness or numbness to her extremities.
She reported to work and a CT scan was done with negative
results. Symptoms continued
and she complained of a "sharp stabbing pain" to her occipital
area .  An MRI was done and an AComm aneurysm reported. An
angiogram was performed revealing an Acomm artery aneurysm, SCA
aneurysm and Cavernous carotid aneurysm. On [**2140-9-19**] she
underwent successful coiling of the acomm artery aneurysm. She
then underwent subsequent clipping of her SCA aneurysm at [**Hospital1 2025**].
On [**5-31**] she underwent stenting of her left ICA aneurysm and she
returns today for subsequent coil embolization.

MEDICAL HISTORY: Acomm artery aneurysm s/p coiling
SCA aneurysm s/p craniotomy and clipping

MEDICATION ON ADMISSION: none

ALLERGIES: Dicloxacillin

PHYSICAL EXAM: On Admission:
nonfocal
AOx3, following commands
CN II-XII intact
Motor: 5/5 strength x 4 extremities
Sensation intact to light touch

FAMILY HISTORY: non contributory

SOCIAL HISTORY: Married, three children age 16, 17 and 20. Works as an ICU
nurse @ [**Hospital1 18**].  Previously smoked, quit six years ago. 2-3drinks
week. 

### Response:
{'Cerebral aneurysm, nonruptured,Personal history of tobacco use'}
