CHIEF COMPLAINT: L SDH

PRESENT ILLNESS: 55 y/o M with history of liver cirrhosis presents s/p 1 day
of headache and unsteady gait per friend presents to OSH. Per
OSH
reports, patient was seen in ED where he seized 3 times and was
found to have L SDH on CT scan of head. He was loaded with
dilantin and intubated, then transferred to [**Hospital1 18**] for further
evaluation and management. Patient is sedated on propofol with a
platelet count of 48 upon arrival to [**Hospital1 **].

MEDICAL HISTORY: liver cirrhosis, bipolar, hepatitis C

MEDICATION ON ADMISSION: Patient Passed Away on [**2128-5-4**] at 5:31 PM after being made CMO.

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: O: BP:125/73 HR:73    R:18       O2Sats: 100%CMV
Gen: patient is intubated on propofol
HEENT: atraumatic, normocephalic
Pupils:4-3mm bilaterally
Neuro:
Minimal EO to stimuli
Pupils 4-3 mm bilaterally
BUE purposeful
BLE w/d to noxious L>R

FAMILY HISTORY: NC

SOCIAL HISTORY: ETOH, drink beer daily
Lives with friend
Subdural hemorrhage,Unspecified septicemia,Acute kidney failure with lesion of tubular necrosis,Pneumonitis due to inhalation of food or vomitus,Septic shock,Portal hypertension,Toxic encephalopathy,Severe sepsis,Compression of brain,Rhabdomyolysis,Delirium due to conditions classified elsewhere,Urinary tract infection, site not specified,Hyposmolality and/or hyponatremia,Other and unspecified coagulation defects,Other ascites,Unspecified vascular insufficiency of intestine,Body Mass Index less than 19, adult,Other postoperative infection,Cardiac complications, not elsewhere classified,Other secondary thrombocytopenia,Congestive heart failure, unspecified,Alcoholic cirrhosis of liver,Bipolar disorder, unspecified,Edema of male genital organs,Other and unspecified alcohol dependence, continuous,Unspecified viral hepatitis C without hepatic coma,Tobacco use disorder,Epilepsy, unspecified, without mention of intractable epilepsy,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Do not resuscitate status,Diarrhea,Electrolytic, caloric, and water-balance agents causing adverse effects in therapeutic use,Other drugs and medicinal substances causing adverse effects in therapeutic use
Subdural hemorrhage,Septicemia NOS,Ac kidny fail, tubr necr,Food/vomit pneumonitis,Septic shock,Portal hypertension,Toxic encephalopathy,Severe sepsis,Compression of brain,Rhabdomyolysis,Delirium d/t other cond,Urin tract infection NOS,Hyposmolality,Coagulat defect NEC/NOS,Ascites NEC,Vasc insuff intest NOS,BMI less than 19,adult,Other postop infection,Surg compl-heart,Sec thrombocytpenia NEC,CHF NOS,Alcohol cirrhosis liver,Bipolar disorder NOS,Edema, male genital orgn,Alcoh dep NEC/NOS-contin,Hpt C w/o hepat coma NOS,Tobacco use disorder,Epilep NOS w/o intr epil,Abn react-surg proc NEC,Do not resusctate status,Diarrhea,Adv eff electrolyte agnt,Adv eff medicinal NEC
Admission Date:  [**2128-4-24**]              Discharge Date:   [**2128-5-4**]

Date of Birth:  [**2073-4-18**]             Sex:   M

Service: MEDICINE

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 99**]
Chief Complaint:
L SDH


Major Surgical or Invasive Procedure:
Patient Passed Away on [**2128-5-4**] at 5:31 PM after being made CMO.

History of Present Illness:
55 y/o M with history of liver cirrhosis presents s/p 1 day
of headache and unsteady gait per friend presents to OSH. Per
OSH
reports, patient was seen in ED where he seized 3 times and was
found to have L SDH on CT scan of head. He was loaded with
dilantin and intubated, then transferred to [**Hospital1 18**] for further
evaluation and management. Patient is sedated on propofol with a
platelet count of 48 upon arrival to [**Hospital1 **].


Past Medical History:
liver cirrhosis, bipolar, hepatitis C


Social History:
ETOH, drink beer daily
Lives with friend

Family History:
NC

Physical Exam:
O: BP:125/73 HR:73    R:18       O2Sats: 100%CMV
Gen: patient is intubated on propofol
HEENT: atraumatic, normocephalic
Pupils:4-3mm bilaterally
Neuro:
Minimal EO to stimuli
Pupils 4-3 mm bilaterally
BUE purposeful
BLE w/d to noxious L>R


Pertinent Results:
CT HEAD W/O CONTRAST [**2128-4-24**]
1. Bilateral subdural hematomas, as above, left greater than
right, with
stable rightward shift and subfalcine and mild/early uncal
herniation.
2. Possible retained foreign body in left frontotemporal soft
tissues, please correlate clinically.
3. Comminuted nasal fractures, likely chronic.

CT HEAD W/O CONTRAST [**2128-4-25**]
1. Post-left subdural evacuation changes, with improved moderate
left
pneumocephalus and overlying subcutaneous emphysema.
2. Unchanged blood layering along the tentorial leaflets.
3. Improved rightward subfalcine herniation.
4. No new hemorrhage or mass effect.

Patient Passed Away on [**2128-5-4**] at 5:31 PM after being made CMO.

Brief Hospital Course:
55 y/o M with hepatitis C andl iver cirrhosis presents to OSH
after 1 day of headachae and unsteadiness. Head CT revealed L
SDH with midline shift. He was transferred to [**Hospital1 18**] for further
neurosurgical intervention. His platelet count at the OSH was
48, repeat head CT showed no increase in hemorrhage, he was
taken emergently to the OR for a L craniotomy for evacuation of
L SDH. OR was uncomplicated and patient was transferred to the
ICU for monitoring overnight. Post op head CT showed
pneumocephalus with good evacuation of blood. On post op
examination, he localized bilateral upper extremities and moved
BLE spontaneously. On [**4-26**], patient was slightly lethargic, but
alert and moving all extremities to commands. He was transferred
to step down unit. He remained stable overnight but he also
remained hyponatremic. A repeat sodium was 135 after being
started on salt tabs.  A repeat urinalysis was also checked to
evaluate the UTI that was treated in the emergency room which
was essentially negative.

On the evening of [**2128-4-27**], patient bacame hypotensive and
required aggressive crystalloid resuscitation.   He responded
reasonably but continued to have hypotension in the AM [**4-28**].  He
required several boluses of IVFs.  NGT was placed in routine
fashion and a CXR confirmed placement in the bowel. Cardiac
enzymes and ECG was obtained to rule out cardiac etiology for
persistent hypotension.  In addition, medicine was consulted for
further recommendations and assistance in management of
hypotension.  CK was elevated at 1028.  ECG showed low voltage
and thus TTE was recommended by medicine as well as urine
studies to rule out rhabdomyolysis.

Required ventilation support for hypoxia.  Continued to become
progressively more hypotensive despite multiple vasopressors.
Decision made by HCP to withdraw treatment and make patient CMO.

Patient Passed Away on [**2128-5-4**] at 5:31 PM after being made CMO.


Medications on Admission:
Patient Passed Away on [**2128-5-4**] at 5:31 PM after being made CMO.

Discharge Medications:
Patient Passed Away on [**2128-5-4**] at 5:31 PM after being made CMO.

Discharge Disposition:
Expired

Discharge Diagnosis:
Patient Passed Away on [**2128-5-4**] at 5:31 PM after being made CMO.

Discharge Condition:
Patient Passed Away on [**2128-5-4**] at 5:31 PM after being made CMO.

Discharge Instructions:
Patient Passed Away on [**2128-5-4**] at 5:31 PM after being made CMO.

Followup Instructions:
Patient Passed Away on [**2128-5-4**] at 5:31 PM after being made CMO.
{'Subdural hemorrhage,Unspecified septicemia,Acute kidney failure with lesion of tubular necrosis,Pneumonitis due to inhalation of food or vomitus,Septic shock,Portal hypertension,Toxic encephalopathy,Severe sepsis,Compression of brain,Rhabdomyolysis,Delirium due to conditions classified elsewhere,Urinary tract infection, site not specified,Hyposmolality and/or hyponatremia,Other and unspecified coagulation defects,Other ascites,Unspecified vascular insufficiency of intestine,Body Mass Index less than 19, adult,Other postoperative infection,Cardiac complications, not elsewhere classified,Other secondary thrombocytopenia,Congestive heart failure, unspecified,Alcoholic cirrhosis of liver,Bipolar disorder, unspecified,Edema of male genital organs,Other and unspecified alcohol dependence, continuous,Unspecified viral hepatitis C without hepatic coma,Tobacco use disorder,Epilepsy, unspecified, without mention of intractable epilepsy,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Do not resuscitate status,Diarrhea,Electrolytic, caloric, and water-balance agents causing adverse effects in therapeutic use,Other drugs and medicinal substances causing adverse effects in therapeutic 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 SDH

PRESENT ILLNESS: 55 y/o M with history of liver cirrhosis presents s/p 1 day
of headache and unsteady gait per friend presents to OSH. Per
OSH
reports, patient was seen in ED where he seized 3 times and was
found to have L SDH on CT scan of head. He was loaded with
dilantin and intubated, then transferred to [**Hospital1 18**] for further
evaluation and management. Patient is sedated on propofol with a
platelet count of 48 upon arrival to [**Hospital1 **].

MEDICAL HISTORY: liver cirrhosis, bipolar, hepatitis C

MEDICATION ON ADMISSION: Patient Passed Away on [**2128-5-4**] at 5:31 PM after being made CMO.

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: O: BP:125/73 HR:73    R:18       O2Sats: 100%CMV
Gen: patient is intubated on propofol
HEENT: atraumatic, normocephalic
Pupils:4-3mm bilaterally
Neuro:
Minimal EO to stimuli
Pupils 4-3 mm bilaterally
BUE purposeful
BLE w/d to noxious L>R

FAMILY HISTORY: NC

SOCIAL HISTORY: ETOH, drink beer daily
Lives with friend 

### Response:
{'Subdural hemorrhage,Unspecified septicemia,Acute kidney failure with lesion of tubular necrosis,Pneumonitis due to inhalation of food or vomitus,Septic shock,Portal hypertension,Toxic encephalopathy,Severe sepsis,Compression of brain,Rhabdomyolysis,Delirium due to conditions classified elsewhere,Urinary tract infection, site not specified,Hyposmolality and/or hyponatremia,Other and unspecified coagulation defects,Other ascites,Unspecified vascular insufficiency of intestine,Body Mass Index less than 19, adult,Other postoperative infection,Cardiac complications, not elsewhere classified,Other secondary thrombocytopenia,Congestive heart failure, unspecified,Alcoholic cirrhosis of liver,Bipolar disorder, unspecified,Edema of male genital organs,Other and unspecified alcohol dependence, continuous,Unspecified viral hepatitis C without hepatic coma,Tobacco use disorder,Epilepsy, unspecified, without mention of intractable epilepsy,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Do not resuscitate status,Diarrhea,Electrolytic, caloric, and water-balance agents causing adverse effects in therapeutic use,Other drugs and medicinal substances causing adverse effects in therapeutic use'}
