<![CDATA[Tumor hipofisis dapat disertai gejala neuropsikiatri. Apopleksia pituitari (AP) merupakan kejadian jarang akibat infark dan perdarahan tumor hipofisis. Pemulihan total masih mungkin terjadi walaupun pada kasus berat dengan terapi pembedahan maupun konservatif. Terapi pembedahan dipilih bila adanya tanda peningkatan intrakranial dengan kondisi klinis dan neurologis yang tidak stabil. Seorang laki laki, umur 36 tahun dengan keluhan gangguan bicara mendadak sehari sebelum masuk RS, dengan riwayat terapi skizofrenia selama 8 bulan. Pasien mengalami penurunan kesadaran dalam perawatan dan didiagnosis tumor hipofisis anterior dengan komponen apopleksia dari CT-scan kepala. Pasca operasi transphenoid urgensi diterapi vasopresin intramuskular akibat poliuria. Penatalaksanaan anestesi pada pembedahan AP tidak berbeda dengan tumor hipofisis lainnya, hanya saja kondisi AP dapat bersifat urgensi. Satu bulan pasca pembedahan, pasien sudah lebih mudah berbicara, mulai beraktifitas fisik, dan halusinasi suara sudah tidak ada. Tatalaksana AP memberikan tantangan dalam manajemennya. Keluhan yang ditemukan dapat berupa halusinasi. Hingga kasus ini dilaporkan, ada satu publikasi kasus AP dengan psikosis akut dan keterlambatan diagnosis masih mungkin terjadi. Kecurigaan gangguan organik tetap perlu dipikirkan pada gangguan neuropsikiatri. Gangguan produksi urin bisa terjadi pasca operasi yang disebabkan beberapa hal sehingga memerlukan pemantauan ketat status hidrasi untuk menghindari morbiditas dan mortalitas yang mungkin terjadi. Anesthesia Management in Urgency Transsphenoidal Tumor Resection with Pituitary Apoplexy Presenting and SchizophreniaAbstractPituitary tumors may be accompanied by neuropsychiatric symptoms. Pituitary Apoplexy (PA) is a rare condition due to infarct or bleeding in pituitary tumors. Complete recovery is still possible even in severe cases with either surgical or conservative therapy. Surgery is a choice if there is evidence of increased intracranial pressure with unstable clinical and neurological conditions. Adult man, 36 yo, with sudden difficulty to speak a day before, with history of schizophrenia since 8 months ago. The patient suffered a decrease in consciousness in hospitalization and was diagnosed with anterior hypophysis tumor with apoplexy by CT-scan results. Post transsphenoidal urgency surgery, the patient was treated with vasopressin IM due to polyuria. Anesthesia management in PA surgery is the same as other pituitary tumor surgery, however, PA can be urgent. One month after surgery, the patient is more easier to talk, start physical activities, and auditory hallucination is not heard again. Management PA had its own challenge. Symptoms can be hallucinations. Until this case was reported, there was one published case of AP with acute psychosis and delay in diagnosis is still possible. Suspicion of organic disorders still needs to be considered in neuropsychiatric disorders. Impaired urine production might occur postoperatively due to several reasons so it requires close monitoring of hydration status to prevent possible morbidity and mortality.]]>
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