CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 50-year-old female
with a history of hypertension and increasing headache over
six days who then developed some neck and back and lower
extremity pain on approximately the sixth day.  The headache
was defined as diffuse, rated at 5/10 in intensity, and not
very responsive to pain medication.  She went to an outside
hospital two days prior to admission where she was evaluated
and felt to have symptoms consistent with migraine headache.
A CT scan of the head was not obtained at that time.  Neck
films were obtained at that time but were normal per report
and she was given naproxen and discharged home.  At the time
of admission to the [**Hospital6 256**], she
stated that her headache awoke her from a sleep with
increasing headache, as well as some nausea and vomiting on
the morning of admission.  There was no diplopia or visual
changes.  She did complain of mild neck pain.  Denied any
weakness and numbness or tingling.

MEDICAL HISTORY: Includes a history of hypertension
and she is status post appendectomy as a 15 year old.

MEDICATION ON ADMISSION: 

ALLERGIES: She has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Subarachnoid hemorrhage,Obstructive hydrocephalus,Other specified transient cerebral ischemias,Candidiasis of other urogenital sites,Unspecified essential hypertension,Anxiety state, unspecified
Subarachnoid hemorrhage,Obstructiv hydrocephalus,Trans cereb ischemia NEC,Candidias urogenital NEC,Hypertension NOS,Anxiety state NOS
Admission Date:  [**2148-2-11**]     Discharge Date:  [**2148-3-7**]

Date of Birth:   [**2098-9-16**]     Sex:  F

Service:

HISTORY OF PRESENT ILLNESS:  This is a 50-year-old female
with a history of hypertension and increasing headache over
six days who then developed some neck and back and lower
extremity pain on approximately the sixth day.  The headache
was defined as diffuse, rated at 5/10 in intensity, and not
very responsive to pain medication.  She went to an outside
hospital two days prior to admission where she was evaluated
and felt to have symptoms consistent with migraine headache.
A CT scan of the head was not obtained at that time.  Neck
films were obtained at that time but were normal per report
and she was given naproxen and discharged home.  At the time
of admission to the [**Hospital6 256**], she
stated that her headache awoke her from a sleep with
increasing headache, as well as some nausea and vomiting on
the morning of admission.  There was no diplopia or visual
changes.  She did complain of mild neck pain.  Denied any
weakness and numbness or tingling.

PREVIOUS MEDICAL HISTORY:  Includes a history of hypertension
and she is status post appendectomy as a 15 year old.

ALLERGIES:  She has no known drug allergies.

CURRENT MEDICATIONS:  Vasotec, Atenolol, Flexeril and
Naprosyn.

PHYSICAL EXAMINATION:  She was afebrile.  Vital signs:  Blood
pressure 157/86.  Heart rate 85.  Respiratory rate 17.  02
saturation 100% on room air.  She was awake and in no acute
distress.  The neck showed bilateral bruises along the
lateral aspects of the neck and shoulders, but was supple to
motion.   Chest was clear to percussion and auscultation.
There were no carotid bruits.  There was a 2/6 systolic
ejection murmur but the heart was otherwise normal sinus
rhythm.  Abdominal exam was unremarkable.  Extremity exam was
unremarkable.  Neurological exam showed mental status, the
patient was awake, alert and oriented times three with fluent
speech, normal naming of objects and normal repetition. She
was drowsy with her eyes closed sporadically throughout the
exam.  Cranial nerves were intact.  Muscles were normal bulk
and tone with full strength 5/5 throughout.  There was no
drift and no asterixis and a sensory exam showed light touch
to be intact throughout.  Deep tendon reflexes were equal
bilaterally.  Toes appeared to be upgoing bilaterally and
there were slightly clumsy dystonia for finger to nose and
rapid alternating movements on the right.

At the time of admission, her white blood cell count was
13.4, hematocrit 35.5, platelet count 285,000.  Coags:  PT
was 11.8, PTT 21.9, INR 1.0.  Chem-7 and urinalysis were
negative and a head CT showed a subarachnoid hemorrhage with
evidence to suggest an aneurysmal rupture.  The patient was
seen in consultation by Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] of Interventional
Neuroradiology who felt that a diagnostic angiogram was
indicated and the patient was taken to the Angiogram Suite
for diagnostic angiogram.  A aneurysm was seen at that time
and the patient underwent a coiling of an anterior
communicating artery aneurysm during the initial procedure.

The patient tolerated the procedure well.  She went to the
Neurological Intensive Care Unit for recovery in stable
condition.  On the morning following the angiogram, the groin
sheath was removed and tolerated well.  A vent drain was
placed at the time of the angiogram and the vent drain
drained clear cerebral spinal fluid for several days.  On
attempts to wean the patient from the vent drain, her mental
status would deteriorate, therefore, the vent drain was
continued for several days.

On [**2-29**], cerebrospinal fluid cultures from [**2-27**], grew out one colony of gram positive rods in one plate
and due to this, the patient was begun on vancomycin and
cephalexin for meningitis and seen in consultation by the
Infectious Disease Service.

The patient tolerated the remainder of her hospitalization.
The drain was slowly elevated as the patient could tolerate
as clinically and the drain was clamped on the [**3-4**] and removed on the [**3-5**].  An lumbar
puncture was done on the [**3-6**] to measure opening
pressure and the opening pressure was 12 (closing pressure
was 10).  The patient tolerated the procedure well and showed
no further mental status changes throughout the remainder of
the hospitalization.  She was subsequently discharged home on
the morning of the [**2148-3-7**] with follow-up to
see Dr. [**Last Name (STitle) 1132**] in the Clinic in approximately two to three
weeks time.  It is important to note, that the patient was
followed throughout her hospitalization by the Psychiatry
Service for history of anxiety and for dealing with her
recent illness.

CONDITION ON DISCHARGE:  Stable and improved.








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

Dictated By:[**Name8 (MD) 5474**]

MEDQUIST36

D:  [**2148-6-9**]  14:05
T:  [**2148-6-9**]  14:05
JOB#:  [**Job Number 38882**]
{'Subarachnoid hemorrhage,Obstructive hydrocephalus,Other specified transient cerebral ischemias,Candidiasis of other urogenital sites,Unspecified essential hypertension,Anxiety state, unspecified'}


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: This is a 50-year-old female
with a history of hypertension and increasing headache over
six days who then developed some neck and back and lower
extremity pain on approximately the sixth day.  The headache
was defined as diffuse, rated at 5/10 in intensity, and not
very responsive to pain medication.  She went to an outside
hospital two days prior to admission where she was evaluated
and felt to have symptoms consistent with migraine headache.
A CT scan of the head was not obtained at that time.  Neck
films were obtained at that time but were normal per report
and she was given naproxen and discharged home.  At the time
of admission to the [**Hospital6 256**], she
stated that her headache awoke her from a sleep with
increasing headache, as well as some nausea and vomiting on
the morning of admission.  There was no diplopia or visual
changes.  She did complain of mild neck pain.  Denied any
weakness and numbness or tingling.

MEDICAL HISTORY: Includes a history of hypertension
and she is status post appendectomy as a 15 year old.

MEDICATION ON ADMISSION: 

ALLERGIES: She has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Subarachnoid hemorrhage,Obstructive hydrocephalus,Other specified transient cerebral ischemias,Candidiasis of other urogenital sites,Unspecified essential hypertension,Anxiety state, unspecified'}
