Spontaneous Intracranial Hypotension — solved with precision. Taipei Veterans General Hospital runs the world's largest dedicated SIH programme, with a targeted blood-patch technique that reaches 92% first-attempt success and has reset the international standard of care.
SIH is a treatable headache disorder that's missed worldwide. Four gaps keep patients suffering — and Taipei VGH closes every one.
Patients cycle through ineffective treatments for years before the real cause is found.
Non-targeted patches fail because the leak site is unknown — meaning repeat procedures.
Without consensus on workup and sequencing, outcomes vary widely between centres.
Untreated SIH can progress to brain sag and subdural haematoma.
Every patient follows a defined protocol with clear outcome thresholds at each step — minimising intervention while maximising recovery. Most resolve before surgery is ever discussed.
Supervised conservative management with structured monitoring for spontaneous resolution.
In-house leak localisation pinpoints the site and type, then a high-volume (≥20 mL) targeted patch is placed.
For persistent leaks, fibrin sealant augmentation and a second targeted patch under imaging.
Definitive repair for refractory dural tears or CSF-venous fistulas — Asia's first dedicated CVF programme.
Taipei VGH's Dynamic CT Myelography pinpoints the CSF leak site and type — the basis for every targeted blood patch performed here.
A 500+ patient prospective registry with 5-year follow-up, imaging archive, and CSF biomarker bank. Others treat SIH; only Taipei VGH studies it at this scale.
A landmark RCT proved high-volume (≥20 mL) targeted blood patch outperforms standard volume — re-treatment down 40%. Now standard in Japan, Korea, UK, Germany.
All figures come from the prospective registry, 5-year follow-up, and validated PROMs.
| Metric | Taipei VGH | Global literature | Δ Improvement | Performance |
|---|---|---|---|---|
| Targeted blood patch success | 92% | 30–50% | +42–62 pt | |
| 1-year recurrence | < 18% | 35–50% | −17–32 pt | |
| Headache-free at 3 months | 87% | 55–65% | +22–32 pt | |
| CT myelography diagnostic accuracy | 94% | 60–75% | +19–34 pt | |
| Median time to relief | 3.2 wk | 8–12 wk | −60–73% | |
| Surgical ligation success (refractory) | 96% | 80–88% | +8–16 pt |
VGHTP's data on high-volume targeted blood patching has redefined the standard of care for SIH — a 92% first-attempt success rate alongside a 1-year recurrence below 18%, levels essentially unmatched elsewhere in the published literature.
Diagnostic criteria and imaging protocol referenced in the ICHD-3 update; epidural blood patch recommendations cite the hospital's high-volume data.
Wang S-J et al. cited 6 times in AAN headache management guidelines.
Landmark RCT adopted as standard protocol in Japan, Korea, UK, and Germany.
Hands-on workshops drawing neurologists from across Asia, Europe, and North America — 200+ physicians trained to date.
Prof. Wang authored the SIH chapter in Headache Medicine, 4th edition.
Across Cephalalgia, Neurology, JAMA Neurology, Brain — 800+ citations, h-index 18.
Neurology, Radiology, and Neurosurgery operate under one unified protocol — so referred patients reach treatment in under two weeks, every time.
Three partnership tracks for different needs — each with a dedicated contact. Average response within five business days.
Refer refractory SIH cases. Pre-assessment, imaging review, and treatment plan within two weeks.
Access the world's largest SIH dataset for joint research — sub-group, biomarker, and multi-centre RCTs.
3–6 month structured fellowship across dynamic CT myelography, targeted patch, and surgical ligation.