CHIEF COMPLAINT: 

PRESENT ILLNESS: This 72 year old female presents
from an outside hospital with right cerebellar bleed after a
fall.  Most of the history is obtained from family at bedside
as well as old notes.  She has been falling over the last
year but increased frequency over the last six to eight
weeks.  She had three falls and most recently had loss of
consciousness.  Her family states that she has had trouble
with her balance over the year and she occasionally gets
confused.  She is also noted to have vague weakness versus
numbness on the left side.  She is unable to further
characterize these symptoms and states she has had left upper
extremity weakness for some time.  She does live by herself
and takes care of herself.  She also notes she has had some
trouble with her memory.

MEDICAL HISTORY: 1.  Thyroid problems.  [**Name (NI) **] longer on medication. She took
herself off because she did not like them.
2.  History of left lower extremity burr a number of months,
possibly a year.
3.  Hypertension, however, she stopped taking her Norvasc due
to dizziness.

MEDICATION ON ADMISSION: 1.  Aspirin a day.
2.  Over the counter Tylenol.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: She lives alone in [**Location (un) 3146**].  Occasional
alcohol.  She quit tobacco fifteen years ago.  She is
retired.
Other and unspecified intracranial hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness,Hyposmolality and/or hyponatremia,Urinary tract infection, site not specified,Unspecified fall,Unspecified essential hypertension,Loss of weight
Brain hem NEC w/o coma,Hyposmolality,Urin tract infection NOS,Fall NOS,Hypertension NOS,Abnormal loss of weight
Admission Date:  [**2105-10-23**]       Discharge Date:  [**2105-10-31**]

Date of Birth:   [**2033-1-28**]       Sex:  F

Service:

HISTORY OF PRESENT ILLNESS:  This 72 year old female presents
from an outside hospital with right cerebellar bleed after a
fall.  Most of the history is obtained from family at bedside
as well as old notes.  She has been falling over the last
year but increased frequency over the last six to eight
weeks.  She had three falls and most recently had loss of
consciousness.  Her family states that she has had trouble
with her balance over the year and she occasionally gets
confused.  She is also noted to have vague weakness versus
numbness on the left side.  She is unable to further
characterize these symptoms and states she has had left upper
extremity weakness for some time.  She does live by herself
and takes care of herself.  She also notes she has had some
trouble with her memory.

PAST MEDICAL HISTORY:
1.  Thyroid problems.  [**Name (NI) **] longer on medication. She took
herself off because she did not like them.
2.  History of left lower extremity burr a number of months,
possibly a year.
3.  Hypertension, however, she stopped taking her Norvasc due
to dizziness.

MEDICATIONS ON ADMISSION:
1.  Aspirin a day.
2.  Over the counter Tylenol.

ALLERGIES:  No known drug allergies.

SOCIAL HISTORY:  She lives alone in [**Location (un) 3146**].  Occasional
alcohol.  She quit tobacco fifteen years ago.  She is
retired.

PHYSICAL EXAMINATION:  Blood pressure 183/93, pulse 72,
respiratory rate 18.  In general, she is an elderly thin
woman in no acute distress.  Neck is limited lateral range of
motion.  Lungs - There were rales.  Cardiovascular - regular
rate and rhythm.  Neurologic - Awake and alert, mostly
cooperative with examination, but persistent normal affect,
oriented to person, year, first the year was [**2006**], then she
stated [**2106**], later corrected again and then said it was [**2106**].
Language is fluent, no dysarthria, no paraphrasic errors.
Naming was intact.  Cranial nerves II through XII were
grossly intact.  Motor strength seemed to be weaker in her
left lower extremity including her iliopsoas was [**4-18**] and
ankle flexion was [**3-18**].  Upper extremity difficult to assess
but left deltoid was 4+/5.  Toes were downgoing. Grasp reflex
was absent.  Other reflexes were brisk throughout.

LABORATORY DATA:  CT showed a 3.0 by 5.0 times 4.0 by 5.0
centimeter cerebellar hemorrhage with mass effect, shift,
surrounding edema compressing the fourth ventricle, some
right cerebellar tonsillar herniation that is essentially
unchanged from outside films done earlier that day.

HOSPITAL COURSE:   She was admitted to the neurosurgical unit
for close observation in Neurosurgical Intensive Care Unit.
Her blood pressure in Intensive Care Unit was kept less than
160.  On the day of admission, she was also seen by the
stroke fellow who recommended a magnetic resonance scan of
the head including susceptibility of T2 to look for other
evidence of a microbleed.  Chest x-ray to look at tobacco
history.  Keep the blood pressure less than 160.  Intravenous
hydration.

Magnetic resonance scan showed a stable hemorrhage in the
right cerebellar hemisphere.  There was no evidence of an
underlying mass, stable compression of the fourth ventricle,
no hydrocephalus at the time of the study.

On her second admission day, [**2105-10-24**], the patient was easily
arousible and answered questions.  Extraocular movements were
full.  Face was symmetric, antigravity on both sides.  She
was monitored in the Intensive Care Unit  . She had a head CT on
[**2105-10-24**], which showed no significant change in the right
cerebellar intraparenchymal hemorrhage with mass effect on
the fourth ventricle and no hydrocephalus.

On [**2105-10-25**], her sodium was noted to be at 128.  She was
started on one liter fluid restriction.  All intravenous
medications were changed to p.o. medications.  She was
started on salt tablets.  She was continued on Mannitol.  On
[**2105-10-28**], she continued to be monitored in the Intensive Care
Unit.  Her CAT scan on [**2105-10-27**], showed no change.  Her
Mannitol was weaned to twice a day.

She was seen by physical therapy and occupational therapy who
felt that she needed functional mobility and balance
training.  They assisted to getting her out of bed twice a
day.

On [**2105-10-28**], she was transferred to the regular surgical
floor where her vital signs remained stable.  Her sodium was
now at 141.  She had a bedside swallow examination done on
[**2105-10-30**], where she was downgraded from solids to puree
texture at that time. She was to maintain thin liquids, pills
have to be given with puree, potentially aggressed, and
maintain basic aspiration precautions.

The patient was treated for a urinary tract infection
starting on [**2105-10-29**], and she was placed on Levofloxacin.

She is being discharged neurologically intact on [**2105-10-31**].
She should follow-up with Dr. [**Last Name (STitle) 739**] in one month in
his clinic WITH REPEAT HEAD CT.  They should call for an
appointment, [**Telephone/Fax (1) 50624**].

MEDICATIONS ON DISCHARGE:
1.  Metoprolol Tartrate 50 mg one half tablet twice a day.
2.  Captopril 12.5 mg three times a day.
3.  Colace 100 mg one twice a day.
4.  Levofloxacin 500 mg one q24hours, to stop on [**2105-11-8**].




                       [**Name6 (MD) 742**] [**Name8 (MD) **], M.D.  [**MD Number(1) 743**]

Dictated By:[**Last Name (NamePattern4) 26792**]
MEDQUIST36

D:  [**2105-10-31**]  11:24
T:  [**2105-10-31**]  14:20
JOB#:  [**Job Number 50625**]
{'Other and unspecified intracranial hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness,Hyposmolality and/or hyponatremia,Urinary tract infection, site not specified,Unspecified fall,Unspecified essential hypertension,Loss of weight'}


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 72 year old female presents
from an outside hospital with right cerebellar bleed after a
fall.  Most of the history is obtained from family at bedside
as well as old notes.  She has been falling over the last
year but increased frequency over the last six to eight
weeks.  She had three falls and most recently had loss of
consciousness.  Her family states that she has had trouble
with her balance over the year and she occasionally gets
confused.  She is also noted to have vague weakness versus
numbness on the left side.  She is unable to further
characterize these symptoms and states she has had left upper
extremity weakness for some time.  She does live by herself
and takes care of herself.  She also notes she has had some
trouble with her memory.

MEDICAL HISTORY: 1.  Thyroid problems.  [**Name (NI) **] longer on medication. She took
herself off because she did not like them.
2.  History of left lower extremity burr a number of months,
possibly a year.
3.  Hypertension, however, she stopped taking her Norvasc due
to dizziness.

MEDICATION ON ADMISSION: 1.  Aspirin a day.
2.  Over the counter Tylenol.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: She lives alone in [**Location (un) 3146**].  Occasional
alcohol.  She quit tobacco fifteen years ago.  She is
retired. 

### Response:
{'Other and unspecified intracranial hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness,Hyposmolality and/or hyponatremia,Urinary tract infection, site not specified,Unspecified fall,Unspecified essential hypertension,Loss of weight'}
