Recognition and Practice of Hypopituitarism After Traumatic Brain Injury and Subarachnoid Hemorrhage in Japan: A Survey

Shigeyuki Tahara; Fumio Otsuka; Takaaki Endo

doi:10.1007/s40120-023-00553-x

Recognition and Practice of Hypopituitarism After Traumatic Brain Injury and Subarachnoid Hemorrhage in Japan: A Survey

Neurol Ther. 2024 Feb;13(1):39-51. doi: 10.1007/s40120-023-00553-x. Epub 2023 Oct 24.

Authors

Shigeyuki Tahara¹, Fumio Otsuka², Takaaki Endo³

Affiliations

¹ Department of Neurological Surgery, Nippon Medical School, Bunkyo-Ku, Tokyo, 113-8603, Japan.
² Department of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School, Kita-Ku, Okayama, 700-8558, Japan.
³ Medical Affairs Department, Novo Nordisk Pharma Ltd., Meiji Yasuda Seimei Bldg. 2-1-1 Marunouchi, Chiyoda-Ku, Tokyo, 100-0005, Japan. tend@novonordisk.com.

Abstract

Introduction: Individuals with traumatic brain injury (TBI) or subarachnoid hemorrhage (SAH) are at a high risk of hypopituitarism, and should benefit from early diagnosis and management. However, data on awareness, attitudes, and practices of physicians treating hypopituitarism post-TBI/SAH are limited. The objectives of this study were to gain an understanding of the awareness of Japanese neurosurgeons and endocrinologists towards hypopituitarism post-TBI/SAH and the need for pituitary function assessments in these patients; and to assess the practices and perspectives of these specialists on screening patients with this condition.

Methods: An observational, cross-sectional study was performed that included a Web-based survey of practicing neurosurgeons managing ≥ 1 new patients with TBI/SAH per year or endocrinologists with ≥ 1 new patients per year with a history of TBI/SAH.

Results: Of the 316 respondents (201 neurosurgeons [male, 95.5%]; 115 endocrinologists [male, 77.4%]), 75.6% of neurosurgeons and 81.7% of endocrinologists were aware of the probable occurrence of hypopituitarism post-TBI/SAH, and 79% neurosurgeons and 93.8% endocrinologists considered pituitary function impairment after TBI/SAH to be either very important or important. Hypopituitarism after TBI/SAH was recognized as an important concern by both neurosurgeons (79%) and endocrinologists (93.8%). Although many respondents agreed that such patients remain undiagnosed and untreated, pituitary function assessment post-TBI/SAH has only been performed to a limited extent. The awareness that post-TBI/SAH hypopituitarism is often transient and can progress over several weeks or months was lower in neurosurgeons (46.8%) than in endocrinologists (66.1%).

Conclusions: The level of awareness of hypopituitarism post-TBI/SAH was lower among Japanese neurosurgeons than among endocrinologists. Educational programs and detailed guidance for the diagnosis and treatment of hypopituitarism post-TBI/SAH are warranted.

Keywords: Awareness; Endocrinologists; Hypopituitarism; Neurosurgeons; Practices; Subarachnoid hemorrhage; Traumatic brain injury.