Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: morphine attending: chief complaint: headache major surgical or invasive procedure: cerebral angiogram x 2 history of present illness: hpi: asked to eval this 65 year old white female with sah. pt is transferred in by ambulance from . per reports she has had neck pain for a few days and then this evening had sudden onset headache. she went to the osh and ct revealed perimesencephalic bleed. past medical history: pmhx: hysterectomy ectopic pregnancies x 2 long bowel syndrome social history: social hx: lives with husband and son in a house / 3 levels / exercises frequently / works as an employee benefits manager family history: unknown physical exam: on arrival physical exam: o: t: af bp:166 /89 hr:57 r 13 100 o2sats gen: wd/wn, uncomfortable. heent: ncat pupils: brisk eomis neck: slight nuchal rigidity neuro: mental status: lethargic, cooperative with exam, normal affect. orientation: oriented to person, place, and date. language: speech fluent with good comprehension and repetition. naming intact. no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils equally round and reactive to light, 3 to 2 mm bilaterally. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength full power throughout. no pronator drift sensation: intact to light touch. no clonus on discharge - she is awake and alert, oriented x 3 with non focal neuro exam except for some diplopia. her groin site is dry, intact and flat. pertinent results: cardiology report ecg study date of 10:21:00 pm sinus bradycardia. modest anterolateral st-t wave changes that are non-specific no previous tracing available for comparison. read by: , intervals axes rate pr qrs qt/qtc p qrs t 54 172 100 446/435 57 27 76 radiology report cta neck w&w/oc & recons study date of 11:20 pm findings: ct head: as was seen on the previous ct study from , there is hemorrhage in the basal cisterns, predominantly in the prepontine cistern, perimesencephalic and quadrigeminal cisterns. ct angiography head: ct angiography of the head demonstrates slight prominence of the origin of the left superior cerebellar artery which could be due to an infundibulum. otherwise, there is no evidence of definite aneurysm greater than 3 mm in size in the anterior and posterior circulation. the evaluation of source images and sagittal maximum intensity projection images demonstrate subtle prominence of vascular structures at the foramen magnum on the left side. this could be due to slightly prominent meningeal arteries arising from the vertebral artery, but correlation with subsequent scheduled cerebral angiography is recommended for further evaluation of this area to exclude any dural arteriovenous malformation or fistula in this location. in the partially visualized cervical arteries, no vascular stenosis or occlusion is seen. impression: 1. subarachnoid hemorrhage is seen in the basal cisterns. 2. no definite aneurysm greater than 3 mm in size noted. subtle prominence of the origin of the left superior cerebral artery appears to be due to an infundibulum. 3. subtle prominence of vascular structures at the foramen magnum could be due to prominent meningeal arteries arising from the vertebral artery. correlation with scheduled cerebral angiography is recommended for evaluation of this area to exclude subtle dural av fistula. comment: this report is provided without the availability of 3d reformatted images. when these images are available and if additional information is obtained, an addendum will be given to this report. radiology report mra brain w/o contrast study date of 11:19 am provisional findings impression: afsn sun 5:04 pm 1. subarachnoid hemorrhage seen. 2. small acute infarcts are seen in the right occipital lobe and right cerebellum. 3. abnormal flow voids are seen at the foramen magnum on the axial t2 images better evaluated on previous ct angiography and cerebral angiography. 4. small retrocerebellar subdural hematoma is seen without significant mass effect on the cerebellum. 5. normal mra head and neck. final report exam: mri of the brain and mra of the head and neck. brain mri: the sagittal t1-weighted images demonstrate a small subdural hematoma in the retrocerebellar region measuring approximately 5 mm in thickness and extending from the c1 level to the level of torcula. there is no significant mass effect on the adjacent cerebellum seen. no abnormal flow voids are seen in this region. there is subarachnoid hemorrhage identified in the basal cisterns as seen previously. there is a small area of restricted diffusion seen within the right cerebellum posteriorly which could be due to a small area of acute infarct. t2 images demonstrate subtle flow voids at the foramen magnum region corresponding to the vascular structures seen on the cta examination noted previously and of the cerebral angiography of . impression: 1. subarachnoid hemorrhage. 2. small retrocerebellar posterior fossa subdural hematoma. 3. small acute infarct in the right cerebellum and in the right occipital region. 4. small abnormal flow voids at the foramen magnum region corresponding to abnormal vascular structures seen on the previous cta and cerebral angiography. mra head: the head mra demonstrates normal flow signal in the arteries of anterior and posterior circulation without stenosis, occlusion, or an aneurysm greater than 3 mm in size. impression: normal mra of the head. mra neck: the gadolinium-enhanced mra of the neck demonstrate no evidence of stenosis or occlusion in the arteries of the neck. no abnormal vascular structures are seen. radiology report mr cervical spine w/o contrast study date of 11:20 am provisional findings impression: afsn sun 5:04 pm pfi: 1. no evidence of abnormal flow void within the cervical spinal canal but subtle abnormal flow voids are seen at the foramen magnum which represent the abnormalities seen on the cerebral angiography and ct angiography and could represent a dural av fistula. 2. small retrocerebellar subdural hematoma is seen. 3. subarachnoid hemorrhage seen in the basal cistern. 4. degenerative changes in the cervical region. 5. no abnormal signal within the spinal cord. findings: there is a small retrocerebellar subdural hematoma identified with minimal meningeal thickenings better visualized on the brain mri of the same day. subarachnoid hemorrhage is seen in the basal cistern. there is no evidence of abnormal flow voids identified in the cervical spinal canal. subtle flow voids at the foramen magnum region are noted better evaluated on the previous cerebral angiography and ct angiography and likely represent a small av fistula. degenerative changes are seen in the cervical region with disc bulging at c3-4 and c4-5 levels. at c5-6, disc bulging posterior ridging minimally indents the spinal cord with mild narrowing of the right foramen. at c6-7, there is disc bulging seen with minimal indentation on the thecal sac and mild bilateral foraminal narrowing. at c7-t1, minimal anterolisthesis of c1-7 over t1 seen. from t2-3 to t3-4 mild degenerative disc disease identified. the spinal cord shows normal intrinsic signal. impression: 1. no evidence of abnormal flow void within the cervical spinal canal but subtle abnormal flow voids are seen at the foramen magnum which represent the abnormalities seen on the cerebral angiography and ct angiography and could represent a dural av fistula. 2. small retrocerebellar subdural hematoma is seen. 3. subarachnoid hemorrhage seen in the basal cistern. 4. degenerative changes in the cervical region. 5. no abnormal signal within the spinal cord. radiology report ct head w/o contrast study date of 3:21 am provisional findings impression: ajy mon 5:29 am pfi: no new or increasing intracranial hemorrhage. subarachnoid blood within the basal cisterns is again noted, right greater than left, with decreased conspicuity on the left compared to the , likely reflecting redistribution. small amount of blood is again seen in the occipital horns of the lateral ventricles. there is no parenchymal edema, mass effect, or hydrocephalus. non-contrast head ct: in comparison to the prior study, there is no new or increased intracranial hemorrhage identified. subarachnoid blood seen in the basal cisterns is minimally changed. in the prepontine cistern appears stable, as in the right perimesencephalic and quadrigeminal cistern, though decreased in conspicuity in the left perimesencephalic and quadrigeminal cistern. this may reflect redistribution. small amount of blood is seen layering within the occipital horns of the lateral ventricles, also as on prior study. there is no intraparenchymal, and no subdural hemorrhage identified. the ventricles and sulci are stable in size. there has been no development of hydrocephalus. there is no shift of midline structures, and there is no evidence of herniation. the -white matter differentiation is preserved, without evidence of acute territorial infarction. there is no mass effect. the osseous structures remain unremarkable. the visualized paranasal sinuses and mastoids are normally aerated. impression: little change in subarachnoid hemorrhage within the basal cisterns. there has been some redistribution, with decreased conspicuity of hemorrhage on the left. there is no new or increasing intracranial hemorrhage identified. cerebral angiogram : impression: subtle sub-occipital epidural avf fed by musculospinal branches of v3-v4 segments of the left vertebral artery with venous drainage via two veins, one vein drained intracranially into the left transverse sigmoid sinus, the other vein drains extracranially into the suboccipital venous plexus. head ct : impression: no significant change in subarachnoid hemorrhage within the basal cisterns. no evidence of new or increasing intracranial hemorrhage. cta/ctp : impression: 1. persistent subarachnoid hemorrhage within the basilar cisterns, not significantly changed. minimally increased intraventricular hemorrhage layering in the occiptal horns of the lateral ventricles. no change in size of ventricles. no definite new hemorrhage identified. 2. no abnormality identified on cta/ctp. please note that perfusion of the posterior fossa is limited due to technique and location. mri should be performed for further evaluation if there is clinical concern of posterior fossa infarct. 3. known dural av fistula is not well identified on today's study and better seen on recent cerebral angiogram. cerebral angiogram: report not available at time of discharge. brief hospital course: pt was admitted through the emergency room to the icu after ct revealed sah. bp was controlled and she was started on nimodipine and dilantin. she underwent cta and later formal angiography which were both negative for aneurysm. she was kept in the icu for close observation. follow ct scan imaging has been stable. a pain consult was obtained to assist in managing the pts headaches. on it was noted that she had some behavioral changes and a head ct was done which was stable. on she was confused and a ctp/cta was peformed which showed no vasospasm. no hydrocephalus was noted. she was kept in the icu for 1 week for close neurological monitoring. on she was cleared for transfer to the step down unit. a second cerebral angiogram was scheduled and performed on . she underwent this procedure without incident. she ambulated afterwards without difficulty. on , patient was reported to have a fall hitting her head on the mattress. she reported headache which was different from the her previous headache. she refused a head ct, she was monitored overnight and headaches treated adequeately with pain meds. she was seen on with no complaints, headache controlled with pain medication and she was discharged home. medications on admission: occasional asa occasional ambien discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. nimodipine 30 mg capsule sig: two (2) capsule po q4h (every 4 hours) for 9 days. disp:*108 capsule(s)* refills:*0* 3. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 4. amlodipine 5 mg tablet sig: 1.5 tablets po daily (daily). 5. butalbital-acetaminophen-caff 50-325-40 mg tablet sig: tablets po q4h (every 4 hours) as needed for headache. disp:*60 tablet(s)* refills:*0* 6. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). 7. gabapentin 300 mg capsule sig: one (1) capsule po tid (3 times a day). 8. oxycodone 10 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po q12h (every 12 hours). disp:*60 tablet sustained release 12 hr(s)* refills:*0* 9. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: subarrachnoid hemorrhage headache discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: angiogram medications: ?????? 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 what to report to office: ?????? changes in vision (loss of vision, blurring, double vision, half vision) ?????? slurring of speech or difficulty finding correct words to use ?????? severe headache or worsening headache not controlled by pain medication ?????? a sudden change in the ability to move or use your arm or leg or the ability to feel your arm or leg ?????? trouble swallowing, breathing, or talking ?????? numbness, coldness or pain in lower extremities ?????? temperature greater than 101.5f for 24 hours ?????? new or increased drainage from incision or white, yellow or green drainage from incisions ?????? bleeding from groin puncture site *sudden, severe bleeding or swelling (groin puncture site) lie down, keep leg straight and have someone apply firm pressure to area for 10 minutes. if bleeding stops, call our office. if bleeding does not stop, call 911 for transfer to closest emergency room! followup instructions: please call the office at for a follow up appointment with dr. to be seen in 4 weeks. you will need a cervical spine mri/a at that time. please see your ophthomologist for a follow up eye exam to evaluate your double vision. you may also come to the eye clinic at . the number is ( procedure: venous catheterization, not elsewhere classified arteriography of cerebral arteries arteriography of cerebral arteries diagnoses: unspecified essential hypertension hyposmolality and/or hyponatremia subarachnoid hemorrhage hypopotassemia acquired absence of both cervix and uterus 

Answer: The patient is high likely exposed to