CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 69-year-old
male with a left middle cerebral artery aneurysm.  The
symptoms have included dizziness, tingling in his left
fingers and difficulty with speech.  The patient denied chest
pain, shortness of breath, edema, dysuria, fever, chills,
cold symptoms.

MEDICAL HISTORY: 1.  Left transient ischemic attacks.
2.  GERD.
3.  Hypertension.
4.  Emphysema.
6.  Six TIAs, the last one six months ago.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Cerebral aneurysm, nonruptured,Other emphysema,Unspecified transient cerebral ischemia,Esophageal reflux,Unspecified essential hypertension,Aphasia
Nonrupt cerebral aneurym,Emphysema NEC,Trans cereb ischemia NOS,Esophageal reflux,Hypertension NOS,Aphasia
Admission Date:  [**2120-3-26**]     Discharge Date:  [**2120-4-2**]

Date of Birth:   [**2051-1-17**]     Sex:  M

Service: Neurosrgery

HISTORY OF THE PRESENT ILLNESS:  The patient is a 69-year-old
male with a left middle cerebral artery aneurysm.  The
symptoms have included dizziness, tingling in his left
fingers and difficulty with speech.  The patient denied chest
pain, shortness of breath, edema, dysuria, fever, chills,
cold symptoms.

PAST MEDICAL HISTORY:
1.  Left transient ischemic attacks.
2.  GERD.
3.  Hypertension.
4.  Emphysema.
6.  Six TIAs, the last one six months ago.

HOME MEDICATIONS:
1.  Atenolol 25 mg q.d.
2.  Univasc 7.5 mg q.d.
3.  Aggrenox 25 mg b.i.d.

ALLERGIES:  The patient has no known drug allergies.

PHYSICAL EXAMINATION ON ADMISSION:  Vital signs:  Pulse 55,
blood pressure 153/74.  General:  The patient is a very
pleasant male, alert and oriented times three, in no acute
distress.  HEENT:  Normocephalic, atraumatic.  Pupils equally
round and reactive to light.  Extraocular movements intact.
Chest: Clear to auscultation bilaterally.  Cardiac:  Regular
rate and rhythm, no murmurs.  Abdomen: Soft, nontender,
nondistended, no hepatosplenomegaly.  Extremities:  No edema.
Neurologic:  Cranial nerves II through XII intact.  Motor
[**5-20**], bilateral upper and lower extremities.  Reflexes 2+ in
the bilateral upper and lower extremities.  No Romberg sign.
No pronator sign.

HOSPITAL COURSE:  The patient was admitted on [**2120-3-26**], taken
directly to the Operating Room where a craniotomy and
clipping of his left MCA aneurysm was performed.  The patient
was sent to the Intensive Care Unit postoperatively for close
observation.

As the patient began to wake up it was evident that the
patient had developed a postoperative aphasia.  The patient
was treated with dexamethasone as well as Dilantin
postoperatively.  The patient did well postoperatively with
the exception of his aphasia for which the patient stayed in
the ICU for some time in an attempt to discern the cause and
be alert for other possible problems.

Over the course of the stay, the patient was placed on
high-dose intravenous fluids in order to increase his blood
pressure which subsequently improved his aphasia.  It was,
therefore, determined that a higher blood pressure would aid
in maintaining better blood flow to his brain speech centers.

Once determined the patient was found to be stable and the
aphasia improving, the patient was discharged to the regular
Neurosurgical Floor where he continued to do well.  During
the course of his stay, his mental status examination and
physical examination continued to be very good.  His aphasia
continued to improve.

The patient was slowly weaned off of his IV fluids which he
tolerated well.  Periodically, over the course of his
weaning, his blood pressure would become slightly lower.  For
that reason, his blood pressure medication regimen was
altered such that he will only be taking only one-quarter of
his at-home Atenolol dose on discharge.

On [**2120-3-28**], the patient had an angiogram to ensure
appropriate patency of his cranial arteries which was
confirmed. The patient did have mild narrowing of his MCA,
although patency was evident.

It is now [**2120-4-2**], and the patient is doing quite well.  He
is being discharged home.  He will be sent home with Percocet
for pain, Colace for constipation.  He will be sent home with
Dilantin 100 mg t.i.d. as well as Atenolol 6.25 mg once a
day.  The patient is not to restart his home medications as
they include blood thinners and hypertensive medications.  He
is to restrict himself to the medications that he is being
discharged on.

Before discharge, he will have his staples removed.  He is to
follow-up with Dr. [**Last Name (STitle) 1132**] in one week.  He may observe regular
activity, although he should not drive while on pain
medication.  The patient may start showering tomorrow.




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

Dictated By:[**Last Name (NamePattern4) 8358**]

MEDQUIST36

D:  [**2120-4-2**]  04:52
T:  [**2120-4-3**]  10:08
JOB#:  [**Job Number 27520**]
{'Cerebral aneurysm, nonruptured,Other emphysema,Unspecified transient cerebral ischemia,Esophageal reflux,Unspecified essential hypertension,Aphasia'}


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 69-year-old
male with a left middle cerebral artery aneurysm.  The
symptoms have included dizziness, tingling in his left
fingers and difficulty with speech.  The patient denied chest
pain, shortness of breath, edema, dysuria, fever, chills,
cold symptoms.

MEDICAL HISTORY: 1.  Left transient ischemic attacks.
2.  GERD.
3.  Hypertension.
4.  Emphysema.
6.  Six TIAs, the last one six months ago.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Cerebral aneurysm, nonruptured,Other emphysema,Unspecified transient cerebral ischemia,Esophageal reflux,Unspecified essential hypertension,Aphasia'}
