CHIEF COMPLAINT: L acoustic neuroma

PRESENT ILLNESS: 51-year-old man with no significant past medical
history who complains of sensation of dizziness, lightheadedness
for the past five months.  The patient denies any vertigo.  He
says the lightheadedness comes on and off most of the days.  He
sometimes has to grab on things because he feels as if he is
going to pass out.  He denies any sweating or tachycardia before
this event.  He has no headaches.  Those events last for about
one to two minutes and resolve spontaneously.  They are not
worse
when he stands up and he does not relate any triggers.

MEDICAL HISTORY: L hearing loss, dizziness

MEDICATION ON ADMISSION: Viagra prn, Claritin prn, ASA 81

ALLERGIES: Hayfever

PHYSICAL EXAM: AVSS
NAD
L ear dressing C/D/I
CTAB
RRR
Abd: soft NT ND, incision C/D/I
Ext: WWP
Neuro: CN II-XII grossly intact with exception of L CN VIII
AAOx3

FAMILY HISTORY: His family is very healthy.  No neurologic
condition in the family

SOCIAL HISTORY: The patient is married.  He has three children.
He has his own business.  He quit smoking 25 years ago (he
smoked
for 10 years).  He drinks four to five glasses of wine per week
and several cups of coffee per day.
Benign neoplasm of cranial nerves,Personal history of tobacco use
Benign neo cranial nerve,History of tobacco use
Admission Date:  [**2107-3-10**]              Discharge Date:   [**2107-3-12**]

Date of Birth:  [**2055-2-22**]             Sex:   M

Service: OTOLARYNGOLOGY

Allergies:
Hayfever

Attending:[**Known firstname 12657**]
Chief Complaint:
L acoustic neuroma

Major Surgical or Invasive Procedure:
Transcochlear translabyrinthine resection of left acoustic
neuroma with facial nerve monitoring and abdominal fat
obliteration.


History of Present Illness:
51-year-old man with no significant past medical
history who complains of sensation of dizziness, lightheadedness
for the past five months.  The patient denies any vertigo.  He
says the lightheadedness comes on and off most of the days.  He
sometimes has to grab on things because he feels as if he is
going to pass out.  He denies any sweating or tachycardia before
this event.  He has no headaches.  Those events last for about
one to two minutes and resolve spontaneously.  They are not
worse
when he stands up and he does not relate any triggers.

Past Medical History:
L hearing loss, dizziness

Social History:
The patient is married.  He has three children.
He has his own business.  He quit smoking 25 years ago (he
smoked
for 10 years).  He drinks four to five glasses of wine per week
and several cups of coffee per day.


Family History:
His family is very healthy.  No neurologic
condition in the family

Physical Exam:
AVSS
NAD
L ear dressing C/D/I
CTAB
RRR
Abd: soft NT ND, incision C/D/I
Ext: WWP
Neuro: CN II-XII grossly intact with exception of L CN VIII
AAOx3

Pertinent Results:
MR [**2107-1-6**]:
There is an enhancing soft tissue lesion involving the left
internal auditory canal, measuring 1.3 cm in long axis and 0.3
cm in short
axis. The lesion extends from the cochlear aperture to the porus
acousticus, and is consistent with a vestibular schwannoma.
There is no evidence of an abnormal enhancing mass on the study
from [**2098**], and this finding is new since that time.
Additionally, there is evidence of enhancement within the
cochlea itself.

The right internal auditory canal is patent, without evidence of
an abnormal soft tissue mass.

The visualized brain demonstrates normal signal intensity and
appearance. The ventricles, sulci and cisterns are age
appropriate. No additional area of abnormal enhancement is
identified. There is no mass effect or midline shift.
There is no extra-axial fluid collection. There is no decreased
diffusion to indicate an acute infarct. The flow voids of the
major vessels are present.

The visualized paranasal sinuses and left mastoid air cells are
clear. There is some small amount of fluid in the right mastoid
air cells. The orbits and soft tissues are intact.

[**2107-3-11**] 02:18AM BLOOD WBC-10.3# RBC-3.91* Hgb-12.1* Hct-36.2*
MCV-93 MCH-31.1 MCHC-33.5 RDW-12.7 Plt Ct-273
[**2107-3-11**] 02:18AM BLOOD Glucose-130* UreaN-11 Creat-0.9 Na-139
K-4.1 Cl-104 HCO3-29 AnGap-10

Brief Hospital Course:
52M admitted for L acoustic neuroma, POD 2 s/p
translabyrinthine, transcochlear resection.  Admitted to TSICU
for q1h neuro checks.  Never developed any facial nerve or other
neurologic deficits.  His diet was advanced as tolerated to
regular which was well-tolerated.  Pt. complaining of some
dizziness post-operatively, which has improved.  He is
ambulating without assistance.  At time of discharge pain well
controlled with oral pain medications, pt. not experiencing
major dizziness, patient ambulating without difficulty, pt.
voiding without difficulty.

Medications on Admission:
Viagra prn, Claritin prn, ASA 81

Discharge Medications:
1. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
every 4-6 hours as needed for pain.
Disp:*30 Tablet(s)* Refills:*0*
2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
3. Augmentin 875-125 mg Tablet Sig: One (1) Tablet PO twice a
day for 1 weeks.
Disp:*14 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
left acoustic neuroma


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


Discharge Instructions:
Leave left ear dressing in place until your follow-up
appointment.
[**Name8 (MD) **] MD [**First Name (Titles) **] [**Last Name (Titles) **] greater than 101.5, increased pain not
controlled with pain medication, new-onset dizziness, increased
redness or drainage from abdominal wound, bleeding or saturated
ear dressing, new onset facial weakness, trouble with speech or
swallowing.
Cover abdominal wound with dry gauze as nescessary.
You may shower. Keep head dry.  Pat dry abdominal wound after
showing.

Followup Instructions:
Call Dr.[**Name (NI) 37129**] office for follow-up appointment
[**Telephone/Fax (1) 29891**].
{'Benign neoplasm of cranial nerves,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: L acoustic neuroma

PRESENT ILLNESS: 51-year-old man with no significant past medical
history who complains of sensation of dizziness, lightheadedness
for the past five months.  The patient denies any vertigo.  He
says the lightheadedness comes on and off most of the days.  He
sometimes has to grab on things because he feels as if he is
going to pass out.  He denies any sweating or tachycardia before
this event.  He has no headaches.  Those events last for about
one to two minutes and resolve spontaneously.  They are not
worse
when he stands up and he does not relate any triggers.

MEDICAL HISTORY: L hearing loss, dizziness

MEDICATION ON ADMISSION: Viagra prn, Claritin prn, ASA 81

ALLERGIES: Hayfever

PHYSICAL EXAM: AVSS
NAD
L ear dressing C/D/I
CTAB
RRR
Abd: soft NT ND, incision C/D/I
Ext: WWP
Neuro: CN II-XII grossly intact with exception of L CN VIII
AAOx3

FAMILY HISTORY: His family is very healthy.  No neurologic
condition in the family

SOCIAL HISTORY: The patient is married.  He has three children.
He has his own business.  He quit smoking 25 years ago (he
smoked
for 10 years).  He drinks four to five glasses of wine per week
and several cups of coffee per day. 

### Response:
{'Benign neoplasm of cranial nerves,Personal history of tobacco use'}
