Cemal ÖZCAN, Atilla İLHAN, Handan Işın ÖZIŞIK, Sibel KIZKIN

Vertebrobaziler yetmezlikte Ginkgo biloba ekstrelerinin transkraniyal doppler ultrasonografi ile değerlendirilmesi: Ön çalışma

Gingko biloba ekstrelerinin serebral kan akımını artırdığı çok sayıda yayınla bildirilmiştir. Ancak, bu konu nispeten ucuz ve noninvaziv bir metod olan Transkranial Doppler US (TCD) ile araştırılmamıştır. Gereç ve Yöntem: İnönü Üniversitesi Tıp Fakültesi Nöroloji polikliniğine, vertebrobaziler yetmezlik bulguları ile başvuran ve TCD ile vertebral arter kan akım hızı 29 cm/sn. nin altında tespit edilen 15 hastada, tedavi öncesi ve sonrası vertebrobaziler kan akım hızları araştırıldı. Bulgular:Çalışma 15 olguda yapıldı. Hastalardaki asıl yakınma olan aralıklı baş dönmesine 4 hastada dengesizlik, 6 hastada bulanık görme eşlik ediyordu. Tüm hastaların kranial tomografi ya da MR görüntüsü normaldi. MR Anjiografi yapılabilen 9 hastanın birinde sol VA dominant, birinde hipoplazi saptandı. Hastalarda ortalama 7,8 hafta Gingko biloba (EGb 761, 28,8 mg/gün) tedavisi sonrasında TCD tekrar edildi. Sonuç: Vertebrobaziler yetmezliği olan hastalarda Ginkgo biloba tedavisi ile her iki vertebral arter kan akım hızlarında istatistiksel olarak anlamlı artış ortaya çıktı (p=0.0001).

Vertebrobasiler insufficiency evaluation the effect on blood flow of Gingko biloba extracts with transcranial doppler in

In many recent studies have indicated that cerebral blood flow increases with the ginkgo biloba extracts therapy. However there are limited rare studies with Transcranial Doppler Ultrasonography (TCD) which, a noninvasive and cost-effective method. Material and Method: We studied 15 patients vertebrobasiler blood flow with TCD before and after therapy. All patients had vertebrobasiler insuffiency symptoms. Vertebrobasiler blood flow of the patients was below 29 cm/sec evaluated with TCD. Results: All patients had intermittent vertigo, 4 patients had ataxia and 6 patients had blurred vision symptoms. Cranial neuroimaging methods including MRI and CT findings were normal in all patients. One patient had vertebral artery hypoplasia and one patient had dominant left vertebral artery in MRI angiography. All patients were ordered ginkgo biloba extracts (EGb 28.8 mg/day, 6-10 weeks). TCD were repeated in all patients after the therapy. Results: The difference of both vertebral arter blood flow between before and after therapy was statistically significant (p

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1. Mc Kenna DJ, Jones K, Hughes K. Efficacy, safety, and use of Ginkgo biloba in clinical and preclinical applications. Alternative Therapies in Health and Medicine 2001;7:5: 70-90.
2. Kleijnen J, Knipschild P. Ginkgo Biloba. The Lancet 1992;340;7:1136-9.
3. O’Hara MA, Kiefer D, Farrell K, Kemper K. A review of 12 commonly used medicinal herbs. Archives of Family Medicine 1998;7;6:523-6.
4. Költringer P, Eber O, Lind P, et al. Mikrozirkulation und viskoelastizitat des vollblutes unter ginkgo biloba extrakt. Eine plazebokontrollierte, randomisierte doppelblind studie. Perfusion 1989;1:28-30.
5. Jung F, Mrowietz C, Kiesewtter H, Wenzel E. Effect of ginkgo biloba on fluidity of blood and peripheral microcirculation in volunteers. Arzneimittelforschung 1990; 40:589-93.
6. Chung KF, Dent G, McCusker M, Guinot PH, Page CP, Barnes PJ. Effect of a ginkgolide mixture in antagonising skin and platelet responses to platelet activating factor in man. Lancet 1987;i:248-51.
7. Braquet P, Hosford D. Ethnopharmacology and the development of natural PAF antagonists as therapeutic agents. J Ethnopharmacol 1991;32:135-9.
8. Mouren X, Caillard P, Schwartz F. Study of the anti-ischemic action of EGb 761 in the treatment of peripheral arterial occlusive disease by Tc Po2 determination. Angiology. 1994:45:413-7.
9. Thomson GJL, Vohra RK, Carr MH, et al. A clinical trial of Ginkgo biloba extract in patients with intermittent claudication. Int Angiology. 1990;9:75-8.
10. Chung HS, Harris A, Ritch R. Ginkgo biloba extract increases ocular blood flow velocity. Ocul Pharmacol Therapeutics 1999;15:233-240.
11. Vorberg G. Ginkgo biloba extract (GBE): a long-term study of chronic cerebral insufficiency in geriatric patients. Clin Trials J 1985;22:149-157.