CHIEF COMPLAINT: intracerebral hemorrhage

PRESENT ILLNESS: Mr. [**Known lastname 61596**] is a 61 year old male presenting as transfer from
and
outside hospital with large ICH. He was found in his garage
unresponsive this evening with a bag of cocaine next to him. He
was last seen well ~6 hours prior. BP at the scene was
220's/110's. He was taken to an OSH where his temperature was
noted to be 88 degrees, head CT revealed a large Left basal
ganglia hemorrhage with extensive intraventricular spread to
lateral, 3, 4th, communicating hydrocephalus and dissection down
into the brainstem. His examination was notable mid position and
equal pupils unreactive to light, intact gag, no purposeful
withdrawal of extremities. He was intubated at the OSH and
transferred to [**Hospital1 18**] for further care. Neurosurgery was
consulted
and based on poor examination and CT findings was not felt to be
a candidate for decompression or drainage.

MEDICAL HISTORY: Hep C on interferon
GERD
HTN

MEDICATION ON ADMISSION: Interferon

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Vitals: T 97 (on bear hugger), BP 160/96, HR 62, R 14, 100% CMV
Gen- critically ill, unresponsive to noxious stimulation
HEENT- NCAT, MMM, Anicteric sclera
Neck- C-collar
CV- RRR, no MRG
Pulm- scattered crackles.
Abd- soft, nd, bs+
Extrem- no CCE

FAMILY HISTORY: Not elicited

SOCIAL HISTORY: Lives with his wife, children in the area. No illicit drug use.
Intracerebral hemorrhage,Communicating hydrocephalus,Cocaine abuse, continuous,Accidental poisoning by central nervous system stimulants,Home accidents,Unspecified viral hepatitis C without hepatic coma,Esophageal reflux,Unspecified essential hypertension
Intracerebral hemorrhage,Communicat hydrocephalus,Cocaine abuse-continuous,Acc poison-cns stimulant,Accident in home,Hpt C w/o hepat coma NOS,Esophageal reflux,Hypertension NOS
Admission Date:  [**2195-1-22**]              Discharge Date:   [**2195-1-23**]

Date of Birth:  [**2133-4-13**]             Sex:   M

Service: NEUROLOGY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 618**]
Chief Complaint:
intracerebral hemorrhage

Major Surgical or Invasive Procedure:
none


History of Present Illness:
Mr. [**Known lastname 61596**] is a 61 year old male presenting as transfer from
and
outside hospital with large ICH. He was found in his garage
unresponsive this evening with a bag of cocaine next to him. He
was last seen well ~6 hours prior. BP at the scene was
220's/110's. He was taken to an OSH where his temperature was
noted to be 88 degrees, head CT revealed a large Left basal
ganglia hemorrhage with extensive intraventricular spread to
lateral, 3, 4th, communicating hydrocephalus and dissection down
into the brainstem. His examination was notable mid position and
equal pupils unreactive to light, intact gag, no purposeful
withdrawal of extremities. He was intubated at the OSH and
transferred to [**Hospital1 18**] for further care. Neurosurgery was
consulted
and based on poor examination and CT findings was not felt to be
a candidate for decompression or drainage.


Past Medical History:
Hep C on interferon
GERD
HTN

Social History:
Lives with his wife, children in the area. No illicit drug use.

Family History:
Not elicited

Physical Exam:
Vitals: T 97 (on bear hugger), BP 160/96, HR 62, R 14, 100% CMV
Gen- critically ill, unresponsive to noxious stimulation
HEENT- NCAT, MMM, Anicteric sclera
Neck- C-collar
CV- RRR, no MRG
Pulm- scattered crackles.
Abd- soft, nd, bs+
Extrem- no CCE

NEUROLOGIC EXAM:
MS- no response to deep noxious stimulation.

CN- pupils equal at 4mm and unreactive to light, gaze
midposition, absent dolls, absent corneal reflex, intact gag. no
response to nasal tickle.

Motor/Sensory- no spontaneous movements. internally rotates
towards noxious stimulus in bilateral UE's. Triple flexion to
noxious in bilateral LE's.

DTR's- brisk, symmetric throughout.

plantar response upgoing bilaterally.


Pertinent Results:
[**2195-1-22**] 10:30PM URINE  bnzodzpn-NEG barbitrt-NEG opiates-NEG
cocaine-POS amphetmn-NEG mthdone-NEG

Head CT-
There is a large parenchymal hemorrhage in the left cerebral
hemisphere, measuring approximately 8.5 x 4.7 in greatest
dimension, with
surrounding edema. Blood products are present in both lateral
ventricles,
third as well as the fourth ventricle. There is mass effect on
the
ipsilateral lateral ventricle body as well as contralateral
ventricular
dilatation. There is 7-mm shift of the septum pellucidum as well
as rightward subfalcine herniation. There is global sulcal
effacement, highly concerning for cerebral edema. There is
obliteration of the suprasellar cistern, as well as
contralateral temporal [**Doctor Last Name 534**] enlargement.
Evaluation of the posterior fossa is limited by an artifact,
however there is high attenuation in the pons and possibly mid
brain, concerning for additional foci of hemorrhage.


Brief Hospital Course:
Mr. [**Known lastname 61596**] is a 61 year old male found unresponsive with
massive intracerebral hemorrhage. Etiology based on location is
likely hypertensive hemorrhage in the setting of cocaine use.
His condition upon arrival was consistent with severe neurologic
injury without chance of meaningful neurologic recovery. The
patient's condition was discussed at length with his wife and
family. He was admitted to the ICU and later extubated for
comfort measures only. The patient expired promptly following
extubation with his family at the bedside.

Medications on Admission:
Interferon

Discharge Medications:
N/A

Discharge Disposition:
Expired

Discharge Diagnosis:
large L basal ganglia


Discharge Condition:
expired


Discharge Instructions:
NA

Followup Instructions:
NA

                             [**Name6 (MD) **] [**Name8 (MD) **] MD, [**MD Number(3) 632**]
{'Intracerebral hemorrhage,Communicating hydrocephalus,Cocaine abuse, continuous,Accidental poisoning by central nervous system stimulants,Home accidents,Unspecified viral hepatitis C without hepatic coma,Esophageal reflux,Unspecified essential hypertension'}


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: intracerebral hemorrhage

PRESENT ILLNESS: Mr. [**Known lastname 61596**] is a 61 year old male presenting as transfer from
and
outside hospital with large ICH. He was found in his garage
unresponsive this evening with a bag of cocaine next to him. He
was last seen well ~6 hours prior. BP at the scene was
220's/110's. He was taken to an OSH where his temperature was
noted to be 88 degrees, head CT revealed a large Left basal
ganglia hemorrhage with extensive intraventricular spread to
lateral, 3, 4th, communicating hydrocephalus and dissection down
into the brainstem. His examination was notable mid position and
equal pupils unreactive to light, intact gag, no purposeful
withdrawal of extremities. He was intubated at the OSH and
transferred to [**Hospital1 18**] for further care. Neurosurgery was
consulted
and based on poor examination and CT findings was not felt to be
a candidate for decompression or drainage.

MEDICAL HISTORY: Hep C on interferon
GERD
HTN

MEDICATION ON ADMISSION: Interferon

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Vitals: T 97 (on bear hugger), BP 160/96, HR 62, R 14, 100% CMV
Gen- critically ill, unresponsive to noxious stimulation
HEENT- NCAT, MMM, Anicteric sclera
Neck- C-collar
CV- RRR, no MRG
Pulm- scattered crackles.
Abd- soft, nd, bs+
Extrem- no CCE

FAMILY HISTORY: Not elicited

SOCIAL HISTORY: Lives with his wife, children in the area. No illicit drug use. 

### Response:
{'Intracerebral hemorrhage,Communicating hydrocephalus,Cocaine abuse, continuous,Accidental poisoning by central nervous system stimulants,Home accidents,Unspecified viral hepatitis C without hepatic coma,Esophageal reflux,Unspecified essential hypertension'}
