CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 67-year-old
gentleman with complaints of headache and fever of 101?????? for
the five days prior to admission with mild nausea, no
vomiting and a severe headache throbbing from the occiput
radiating the front.  No complaints of blurry vision.  He was
Zithromax for a question of otitis media.

MEDICAL HISTORY: 1.  Depression with history of suicidal ideations
2.  Hypertension
3.  Increased cholesterol
4.  Atrial fibrillation
6.  Leg cramps
7.  Hemorrhoids

MEDICATION ON ADMISSION: 

ALLERGIES: IVP DYE

PHYSICAL EXAM: VITAL SIGNS:  Temperature was 99.1??????.  Blood pressure was
145/75.  Respiratory rate was 18.  His saturations were 97%
on room air.
GENERAL:  He was awake and alert, oriented x3 with fluent
speech.
HEAD, EARS, EYES, NOSE AND THROAT:  His tympanic membranes
were clear bilaterally.  His EOMs were full.  His pupils
equal, round and reactive to light.  His face was symmetric.
His tongue and palate were midline.
NEUROLOGIC:  His shoulder shrug was [**3-31**].  He had no drift,
5/5 strength in all muscle groups.  His reflexes were
symmetric and equal on both sides.  He had no neck stiffness
but worsening headache with flexion and extension of the
neck.

FAMILY HISTORY: 

SOCIAL HISTORY: 
Subarachnoid hemorrhage,Atrial fibrillation,Unspecified essential hypertension,Depressive disorder, not elsewhere classified,Pure hypercholesterolemia
Subarachnoid hemorrhage,Atrial fibrillation,Hypertension NOS,Depressive disorder NEC,Pure hypercholesterolem
Admission Date:  [**2171-3-8**]       Discharge Date:  [**2171-3-20**]

Date of Birth:   [**2103-10-8**]       Sex:  M

Service:  NEUROSURGERY
HISTORY OF PRESENT ILLNESS:  The patient is a 67-year-old
gentleman with complaints of headache and fever of 101?????? for
the five days prior to admission with mild nausea, no
vomiting and a severe headache throbbing from the occiput
radiating the front.  No complaints of blurry vision.  He was
Zithromax for a question of otitis media.

PAST MEDICAL HISTORY:
1.  Depression with history of suicidal ideations
2.  Hypertension
3.  Increased cholesterol
4.  Atrial fibrillation
6.  Leg cramps
7.  Hemorrhoids

ALLERGIES:  IVP DYE

PHYSICAL EXAM:
VITAL SIGNS:  Temperature was 99.1??????.  Blood pressure was
145/75.  Respiratory rate was 18.  His saturations were 97%
on room air.
GENERAL:  He was awake and alert, oriented x3 with fluent
speech.
HEAD, EARS, EYES, NOSE AND THROAT:  His tympanic membranes
were clear bilaterally.  His EOMs were full.  His pupils
equal, round and reactive to light.  His face was symmetric.
His tongue and palate were midline.
NEUROLOGIC:  His shoulder shrug was [**3-31**].  He had no drift,
5/5 strength in all muscle groups.  His reflexes were
symmetric and equal on both sides.  He had no neck stiffness
but worsening headache with flexion and extension of the
neck.

IMAGING AND LABS:  CT showed no acute blood.  He did have a
LP which showed 2400 white cells and [**Pager number **],000 red cells.  It
was moderately xanthochromic which was consistent with
possible subarachnoid hemorrhage versus meningitis.

HOSPITAL COURSE:  The patient was admitted to the Surgical
Intensive Care Unit and underwent a diagnostic arteriogram
which showed evidence of a anterior communicating artery (ACOMM)
aneurysm. On [**3-9**], the patient underwent a right patronal
craniotomy for clipping of an ACOMM aneurysm.  The patient was
monitored in the Surgical Intensive Care Unit.  He remained
afebrile with stable vital signs.  Pupils were 4 down to 2 mm,
moving all extremities strongly.  His chest was clear to
auscultation and his cardiac status was stable.

On [**2171-3-10**], the patient underwent a repeat diagnostic
angiogram which showed good clipping of the aneurysm with no
residual aneurysm and clip was in good placement.  The
patient remained in the Surgical Intensive Care Unit until
[**3-18**] where he was monitored for presence of vasospasm.  The
patient had transcranial Dopplers which showed no evidence of
vasospasm.  The patient remained stable throughout his stay
in the Intensive Care Unit.  He was transferred to the
regular floor on [**2171-3-18**].  He was seen by physical therapy
and occupational therapy and found to require a short
rehabilitation stay prior to discharge to home.  His
intravenous fluid was discontinued on [**2171-3-19**].

DISCHARGE MEDICATIONS:
1.  Miconazole powder 2% one application topically [**Hospital1 **] prn
2.  Dilantin 200 mg po tid
3.  Zantac 150 mg po bid
4.  Prazosin 2 mg po bid
5.  Heparin 5000 units subcutaneous q 12 hours
6.  Risperdal 0.5 mg po q hs
7.  Nimodipine 60 mg po q4h to be continued until [**2171-3-30**] and then discontinued.

DISCHARGE CONDITION:  The patient was in stable condition at
the time of discharge.

FOLLOW UP:  Will follow up with Dr. [**Last Name (STitle) 1132**] in two weeks.

Staples were removed and his incision is clean and dry.




                            [**Name6 (MD) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 1133**]

Dictated By:[**Last Name (NamePattern1) 344**]
MEDQUIST36

D:  [**2171-3-19**]  14:20
T:  [**2171-3-19**]  14:24
JOB#:  [**Job Number 16815**]


Admission Date:  [**2171-3-8**]       Discharge Date:  [**2171-3-20**]

Date of Birth:   [**2103-10-8**]       Sex:  M

Service:  NEUROSURGERY
HISTORY OF PRESENT ILLNESS:  The patient is a 67-year-old
gentleman with complaints of headache and fever of 101?????? for
the five days prior to admission with mild nausea, no
vomiting and a severe headache throbbing from the occiput
radiating the front.  No complaints of blurry vision.  He was
Zithromax for a question of otitis media.

PAST MEDICAL HISTORY:
1.  Depression with history of suicidal ideations
2.  Hypertension
3.  Increased cholesterol
4.  Atrial fibrillation
6.  Leg cramps
7.  Hemorrhoids

ALLERGIES:  IVP DYE

PHYSICAL EXAM:
VITAL SIGNS:  Temperature was 99.1??????.  Blood pressure was
145/75.  Respiratory rate was 18.  His saturations were 97%
on room air.
GENERAL:  He was awake and alert, oriented x3 with fluent
speech.
HEAD, EARS, EYES, NOSE AND THROAT:  His tympanic membranes
were clear bilaterally.  His EOMs were full.  His pupils
equal, round and reactive to light.  His face was symmetric.
His tongue and palate were midline.
NEUROLOGIC:  His shoulder shrug was [**3-31**].  He had no drift,
5/5 strength in all muscle groups.  His reflexes were
symmetric and equal on both sides.  He had no neck stiffness
but worsening headache with flexion and extension of the
neck.

IMAGING AND LABS:  CT showed no acute blood.  He did have a
LP which showed 2400 white cells and [**Pager number **],000 red cells.  It
was moderately xanthochromic which was consistent with
possible subarachnoid hemorrhage versus meningitis.

HOSPITAL COURSE:  The patient was admitted to the Surgical
Intensive Care Unit and underwent a diagnostic arteriogram
which showed evidence of an anterior communicating artery (ACOMM)
aneurysm. On [**3-9**], the patient underwent a right pterional
craniotomy for clipping of an ACOM aneurysm.  The patient was
monitored in the Surgical Intensive Care Unit.  He remained
afebrile with stable vital signs.  Pupils were 4 down to 2 mm,
moving all extremities strongly.  His chest was clear to
auscultation and his cardiac status was stable.

On [**2171-3-10**], the patient underwent a post-surgery diagnostic
angiogram which showed good clipping of the aneurysm with no
residual aneurysm.  The patient remained in the Surgical
Intensive Care Unit until [**3-18**] where he was monitored for
presence of vasospasm.  The patient had transcranial Dopplers
which showed no evidence of vasospasm.  The patient remained
stable throughout his stay in the Intensive Care Unit.  He was
transferred to the regular floor on [**2171-3-18**].  He was seen by
physical therapy and occupational therapy and found to require a
short rehabilitation stay prior to discharge to home.  His
intravenous fluid was discontinued on [**2171-3-19**].

DISCHARGE MEDICATIONS:
1.  Miconazole powder 2% one application topically [**Hospital1 **] prn
2.  Dilantin 200 mg po tid
3.  Zantac 150 mg po bid
4.  Prazosin 2 mg po bid
5.  Heparin 5000 units subcutaneous q 12 hours
6.  Risperdal 0.5 mg po q hs
7.  Nimodipine 60 mg po q4h to be continued until [**2171-3-30**] and then discontinued.

DISCHARGE CONDITION:  The patient was in stable condition at
the time of discharge.

FOLLOW UP:  Will follow up with Dr. [**Last Name (STitle) 1132**] in two weeks.

Staples were removed and his incision is clean and dry.




                            [**Name6 (MD) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 1133**]

Dictated By:[**Last Name (NamePattern1) 344**]
MEDQUIST36

D:  [**2171-3-19**]  14:20
T:  [**2171-3-19**]  14:24
JOB#:  [**Job Number 16816**]
{'Subarachnoid hemorrhage,Atrial fibrillation,Unspecified essential hypertension,Depressive disorder, not elsewhere classified,Pure hypercholesterolemia'}


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 a 67-year-old
gentleman with complaints of headache and fever of 101?????? for
the five days prior to admission with mild nausea, no
vomiting and a severe headache throbbing from the occiput
radiating the front.  No complaints of blurry vision.  He was
Zithromax for a question of otitis media.

MEDICAL HISTORY: 1.  Depression with history of suicidal ideations
2.  Hypertension
3.  Increased cholesterol
4.  Atrial fibrillation
6.  Leg cramps
7.  Hemorrhoids

MEDICATION ON ADMISSION: 

ALLERGIES: IVP DYE

PHYSICAL EXAM: VITAL SIGNS:  Temperature was 99.1??????.  Blood pressure was
145/75.  Respiratory rate was 18.  His saturations were 97%
on room air.
GENERAL:  He was awake and alert, oriented x3 with fluent
speech.
HEAD, EARS, EYES, NOSE AND THROAT:  His tympanic membranes
were clear bilaterally.  His EOMs were full.  His pupils
equal, round and reactive to light.  His face was symmetric.
His tongue and palate were midline.
NEUROLOGIC:  His shoulder shrug was [**3-31**].  He had no drift,
5/5 strength in all muscle groups.  His reflexes were
symmetric and equal on both sides.  He had no neck stiffness
but worsening headache with flexion and extension of the
neck.

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Subarachnoid hemorrhage,Atrial fibrillation,Unspecified essential hypertension,Depressive disorder, not elsewhere classified,Pure hypercholesterolemia'}
