CHIEF COMPLAINT: none

PRESENT ILLNESS: 60-year-old female who had an unruptured left middle cerebral
artery aneurysm. We had electively coiled it with the assistance
of a stent.  Initially, we had placed enough coils  without
complete obliteration.  She now came back for followup to see
whether she needs more coils to be placed.  An MRI was done
which revealed possible recannulization. It was decided to bring
her back electively for an angiogram under anesthesia with
possible recoiling.

MEDICAL HISTORY: lumpectomy and radiation [**2130**]

MEDICATION ON ADMISSION: pepcid, asa 325

ALLERGIES: Penicillins

PHYSICAL EXAM: [**10-22**]: non focal. + soft hematoma @ right groin access site.
distal pulses intact.

FAMILY HISTORY: Family history is significant for mother who had heart valve
replacement.

SOCIAL HISTORY: She works as a computer trainer and has smoked in the past and
in
the last 15 years she smoked a pack per week.  She takes about
four glasses of wine on a nightly basis.
Cerebral aneurysm, nonruptured,Hematoma complicating a procedure,Personal history of malignant neoplasm of breast,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure
Nonrupt cerebral aneurym,Hematoma complic proc,Hx of breast malignancy,Abn react-procedure NEC
Admission Date:  [**2144-10-21**]              Discharge Date:   [**2144-10-22**]

Date of Birth:  [**2084-8-18**]             Sex:   F

Service: NEUROSURGERY

Allergies:
Penicillins

Attending:[**First Name3 (LF) 78**]
Chief Complaint:
none

Major Surgical or Invasive Procedure:
[**2144-10-21**]: Cerebral Angiogram, recoiling of left MCA aneurysm


History of Present Illness:
60-year-old female who had an unruptured left middle cerebral
artery aneurysm. We had electively coiled it with the assistance
of a stent.  Initially, we had placed enough coils  without
complete obliteration.  She now came back for followup to see
whether she needs more coils to be placed.  An MRI was done
which revealed possible recannulization. It was decided to bring
her back electively for an angiogram under anesthesia with
possible recoiling.

Past Medical History:
lumpectomy and radiation [**2130**]

Social History:
She works as a computer trainer and has smoked in the past and
in
the last 15 years she smoked a pack per week.  She takes about
four glasses of wine on a nightly basis.


Family History:
Family history is significant for mother who had heart valve
replacement.


Physical Exam:
[**10-22**]: non focal. + soft hematoma @ right groin access site.
distal pulses intact.

Brief Hospital Course:
Pt electively presented and underwent an angiogram and recoiling
of her recannulized L MCA aneurysm. This was performed without
complication and she tolerated it well. She was extubated and
transferred to the ICU. She was kept on a heparin drip overnight
which was d/c'd at 7AM on [**10-22**]. She was neurologically intact
except for a soft hematoma at her right groin access site. This
had remained stable, and distal pulses were intact.
She was ambulating independently, tolerating a PO diet and
voiding without difficulty. She was cleared for discharge home
and was in agreement with this plan.

Medications on Admission:
pepcid, asa 325

Discharge Medications:
1. Acetaminophen 325-650 mg PO Q6H:PRN pain, T>38.5
2. Aspirin 325 mg PO DAILY
3. Famotidine 20 mg PO BID
4. OxycoDONE (Immediate Release)  5 mg PO Q6H:PRN pain
RX *oxycodone 5 mg 1 tablet(s) by mouth q6hrs Disp #*20 Tablet
Refills:*0


Discharge Disposition:
Home

Discharge Diagnosis:
Left MCA aneurysm recannulization

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

Discharge Instructions:
Angiogram with Embolization
Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) **]
Medications:
??????	Take Aspirin 325mg (enteric coated) 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:
** Please call [**Telephone/Fax (1) 1669**] to make a follow up appointment with
Dr [**First Name (STitle) **] in ___6___ Months. You will require the following
imaging prior to this appointment: MRI/MRA [**Doctor Last Name **] protocol


Completed by:[**2144-10-22**]
{'Cerebral aneurysm, nonruptured,Hematoma complicating a procedure,Personal history of malignant neoplasm of breast,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure'}


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: none

PRESENT ILLNESS: 60-year-old female who had an unruptured left middle cerebral
artery aneurysm. We had electively coiled it with the assistance
of a stent.  Initially, we had placed enough coils  without
complete obliteration.  She now came back for followup to see
whether she needs more coils to be placed.  An MRI was done
which revealed possible recannulization. It was decided to bring
her back electively for an angiogram under anesthesia with
possible recoiling.

MEDICAL HISTORY: lumpectomy and radiation [**2130**]

MEDICATION ON ADMISSION: pepcid, asa 325

ALLERGIES: Penicillins

PHYSICAL EXAM: [**10-22**]: non focal. + soft hematoma @ right groin access site.
distal pulses intact.

FAMILY HISTORY: Family history is significant for mother who had heart valve
replacement.

SOCIAL HISTORY: She works as a computer trainer and has smoked in the past and
in
the last 15 years she smoked a pack per week.  She takes about
four glasses of wine on a nightly basis. 

### Response:
{'Cerebral aneurysm, nonruptured,Hematoma complicating a procedure,Personal history of malignant neoplasm of breast,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure'}
