CHIEF COMPLAINT: cerebral aneurysms

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**].
She returns today for diagnostic angiography and possible
recoiling.

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

MEDICATION ON ADMISSION: none

ALLERGIES: Dicloxacillin

PHYSICAL EXAM: [**6-1**] nonfocal. bilateral groins c/d/i

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,Surgical or other procedure not carried out because of contraindication
Nonrupt cerebral aneurym,History of tobacco use,No proc/contraindication
Admission Date:  [**2141-5-31**]              Discharge Date:   [**2141-6-1**]

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

Service: NEUROSURGERY

Allergies:
Dicloxacillin

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

Major Surgical or Invasive Procedure:
[**2141-5-31**]: Cerebral Angiogram and stenting of left ICA


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**].
She returns today for diagnostic angiography and possible
recoiling.


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:
[**6-1**] nonfocal. bilateral groins c/d/i

Brief Hospital Course:
Pt electively presented and underwent a cerebral angiogram under
general anesthesia. Her AComm artery and SCA aneurysms were
stable without recannulization. The left ICA cavernous aneurysm
was stable but it was difficult to confirm whether it was truely
cavernous vs petrous. Therefore it was decided the best choice
would be to embolize it. She was loaded with Plavix 600mg and
Integrillin 15mg and a stent was deployed in the L ICA. Coiling
of the aneurysm was attempted through the stent but aborted due
to stent movement. She was then transferred to the ICU and
successfully extubated. Her 3f left arterial line was removed at
midnight without difficulty.  She remained neurologically stable
overnight. Her right arterial sheath was removed at 730am
without difficulty. She remained on flat bedrest until 1530. Her
activity was then slowly increased. Groins remained stable so
she was cleared for discharge.

Medications on Admission:
none

Discharge Medications:
1. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*2*
2. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
3. oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours)
as needed for pain.
Disp:*20 Tablet(s)* Refills:*0*
4. cyclobenzaprine 10 mg Tablet Sig: One (1) Tablet PO TID (3
times a day) as needed for back pain.
Disp:*15 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
Acomm artery aneurysm s/p coiling
SCA aneurysm s/p clipping


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
Medications:
??????	Take Aspirin 325mg (enteric coated) once daily.
??????	Take Plavix (Clopidogrel) 75mg once daily.
??????	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:
* Dr [**First Name (STitle) **] will see you in one month. If you have any questions
or issues please call [**Telephone/Fax (1) 1669**].



Completed by:[**2141-6-1**]
{'Cerebral aneurysm, nonruptured,Personal history of tobacco use,Surgical or other procedure not carried out because of contraindication'}


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: cerebral aneurysms

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**].
She returns today for diagnostic angiography and possible
recoiling.

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

MEDICATION ON ADMISSION: none

ALLERGIES: Dicloxacillin

PHYSICAL EXAM: [**6-1**] nonfocal. bilateral groins c/d/i

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,Surgical or other procedure not carried out because of contraindication'}
