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: pristiq attending: chief complaint: headache. major surgical or invasive procedure: none. history of present illness: this is a 47-year-old right handed woman who presented to the ed today after significant right-sided pounding headaches that have been present since tuesday . she states that the headaches had started gradually and felt like a pounding/hammering feeling that had improved significantly over the weekend, but increased in severity on monday and tuesday of and . she said she did not feel any improvement with medications. she then felt that the pain started traveling down into her neck on the right side. her family noticed on tuesday that she had some drooping of her right eye and thought that she should be evaluated. she was taken to hospital on where she had a ct which showed chronic l temporal encephalomalacia from and old tbi at the age of 4 years old. she had an mri/a which showed no acute infarcts, but had chronic left temporal and left basal ganglia infarcts as well as a complete occlusion of the right internal carotid artery. she was transferred to for possible interventional procedure. she states that approximately 8 weeks ago she slipped and fell in the shower and hit the right side of her head. she had significant bruising over the right eye at the time. there was no loc at the time, and no bowel or bladder incontinence to suggest seizure. on neuro ros, the pt denies dysarthria, dysphagia, lightheadedness, vertigo, tinnitus or hearing difficulty. denies difficulties producing or comprehending speech. denies focal weakness, numbness, parasthesiae. no bowel or bladder incontinence or retention. denies difficulty with gait. on general review of systems, the pt denies recent fever or chills. no night sweats or recent weight loss or gain. denies cough, shortness of breath. denies chest pain or tightness, palpitations. denies nausea, vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. denies arthralgias or myalgias. denies rash. rrently. past medical history: - traumatic brain injury at 4 years old with left temporal iph - seizure disorder - characterized as staring spells (thought to be complex partial seizures from tbi) no seizures in 30+ years - depression - on lamictal and lexapro - migraines social history: smoker - 1 pack every 3 days (restarted 2 years ago when her brother died) minimal drinker lives with her 2 children who are 4 years old and 6 years old family history: unknown. physical exam: o: t: 99.9 bp: 120/74 hr: 72 r 14 o2sats 94% gen: wd/wn, comfortable, nad. heent: pupils: 2.5->2mm sluggish bilat eoms intact, r ptosis neck: supple. lungs: cta bilaterally. cardiac: rrr. s1/s2. abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: awakens to stim, cooperative with exam, normal affect. orientation: oriented to person, place, and date. recall: objects at 5 minutes. 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, 2.5 to 2 mm bilaterally. visual fields are full to confrontation except r superior quadrantanopsia. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric except r ptosis 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, propioception, pinprick and vibration bilaterally. toes downgoing bilaterally coordination: normal on finger-nose-finger, rapid alternating movements, heel to shin pertinent results: admission labs: 10:59pm blood wbc-8.2 rbc-4.29 hgb-13.9 hct-41.0 mcv-96 mch-32.4* mchc-34.0 rdw-12.6 plt ct-178 10:59pm blood neuts-89.1* lymphs-8.3* monos-1.2* eos-0.9 baso-0.5 10:59pm blood pt-12.1 ptt-25.3 inr(pt)-1.0 10:59pm blood glucose-104* urean-11 creat-0.8 na-139 k-4.1 cl-102 hco3-28 angap-13 10:59pm blood calcium-9.2 phos-3.4 mg-1.9 discharge labs: 06:05am blood wbc-4.5 rbc-4.16* hgb-13.5 hct-38.6 mcv-93 mch-32.5* mchc-35.0 rdw-12.5 plt ct-185 06:05am blood pt-27.9* inr(pt)-2.7* 06:05am blood plt ct-185 06:45am blood pt-24.6* ptt-66.7* inr(pt)-2.3* 06:05am blood glucose-82 urean-7 creat-0.7 na-137 k-3.5 cl-102 hco3-24 angap-15 04:50am blood calcium-8.6 phos-2.8 mg-1.8 ekg sinus bradycardia with minor non-diagnostic repolarization abnormalities. no previous tracing available for comparison. rate pr qrs qt/qtc p qrs t 60 168 86 396/396 37 42 21 ct perfusion impression: 1. no evidence of acute infarction. note that mri is more sensitive for small infarction. 2. delayed transit time in the right mca and watershed territory. cerebral angiogram impression: 1. severe stenosis of the distal to the carotid bulb, likely due to a dissection. 2. left mca vasculopathy. 3. r mca bifurcation aneurysm. 4. good filling of the right sided cerebral circulation via acom and right pcom arteries. brief hospital course: carotid dissection mrs. presented with right horner's sign right-sided neck pain and headache. the topography of pain referral and presence of horner's sign placed a probable dissection of the internal carotid at the skull base on the right. she was anticoagulated with heparin until coumadin had elevated inr above 2.0. she will need to continue on coumadin for three to six months. she will follow-up in stroke clinic. vascular imaging will be repeated at that time. headache analgesics were given to alleviate headache and neck pain (see medication list). medications on admission: - lamictal 300 mg qd - lexapro 10 mg qd discharge medications: 1. escitalopram 10 mg tablet sig: three (3) tablet po daily (daily). 2. lamotrigine 100 mg tablet sig: three (3) tablet po daily (daily). 3. warfarin 2.5 mg tablet sig: one (1) tablet po once daily at 4 pm. disp:*60 tablet(s)* refills:*2* 4. oxycodone 5 mg tablet sig: one (1) tablet po every eight (8) hours as needed for pain for 3 days. disp:*9 tablet(s)* refills:*0* 5. please consider taking colace or senna if using oxycodone - this medication can be constipating. discharge disposition: home discharge diagnosis: primary right carotid dissection with incavernous occlusion discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital with headache, right neck pain and a droopy right eye. you were found to have a right carotid dissection. you did not have a stroke. you were started on anti-coagulation. your inr is currently therapeutic. you will need to follow-up with your pcp for the inr range. you should also have a level drawn tomorrow at your primary care's office. please call that office tomorrow morning to let them know that you're coming (we have spoken to them and they are expecting your call): . you should also follow-up your clinic appointment and have vessel imaging performed before the appointment. you should avoid carrying heavy weights, chiropactic manipulation and neck trauma. followup instructions: please go to your primary care doctor tomorrow morning to have your blood test for coagulation given that you are taking coumadin. they are expecting you to come in as stated above. you also have an appointment with your primary care doctor y this week at 1:15 p.m. please go to on to have imaging performed prior to your appointment. in order to have this done, you will also need to have a laboratory. neurology: , md, phd: date/time: 2:30 md, procedure: arteriography of cerebral arteries diagnoses: dissection of carotid artery 

Answer: The patient is high likely exposed to