Clinical neurology and neurosurgery Journal Impact Factor & Information

Publisher: Elsevier

Current impact factor: 1.13

Impact Factor Rankings

2015 Impact Factor Available summer 2016
2014 Impact Factor 1.127
2013 Impact Factor 1.248
2012 Impact Factor 1.234
2011 Impact Factor 1.581
2010 Impact Factor 1.636
2009 Impact Factor 1.303
2008 Impact Factor 1.323
2007 Impact Factor 1.553
2006 Impact Factor 1.506
2005 Impact Factor 1.089
2004 Impact Factor 0.954
2003 Impact Factor 0.771
2002 Impact Factor 0.743
2001 Impact Factor 0.595
2000 Impact Factor 0.619
1999 Impact Factor 0.564
1998 Impact Factor 0.406
1997 Impact Factor 0.613
1996 Impact Factor 0.619
1995 Impact Factor 0.594
1994 Impact Factor 0.489
1993 Impact Factor 0.326
1992 Impact Factor 0.353

Impact factor over time

Impact factor

Additional details

5-year impact 1.29
Cited half-life 5.60
Immediacy index 0.14
Eigenfactor 0.01
Article influence 0.38
ISSN 1872-6968

Publisher details


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
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  • Conditions
    • Authors pre-print on any website, including arXiv and RePEC
    • Author's post-print on author's personal website immediately
    • Author's post-print on open access repository after an embargo period of between 12 months and 48 months
    • Permitted deposit due to Funding Body, Institutional and Governmental policy or mandate, may be required to comply with embargo periods of 12 months to 48 months
    • Author's post-print may be used to update arXiv and RepEC
    • Publisher's version/PDF cannot be used
    • Must link to publisher version with DOI
    • Author's post-print must be released with a Creative Commons Attribution Non-Commercial No Derivatives License
    • Publisher last reviewed on 03/06/2015
  • Classification

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: While gross total resection of spinal ependymomas prevents recurrence, this surgical result is not always possible. Increasing evidence suggests that ependymomas occurring in the spine are genetically distinct from those originating in the brain. Herein we review the most recent developments detailing the molecular and genetic characteristics of spinal ependymomas, which may inform more effective and personalized adjuvant therapies for spinal ependymomas that are ineligible for gross total resection. We performed a key-word search for articles published on the molecular, genetic, chromosomal, and epigenetic transformations inherent in spinal ependymomas. We reviewed appropriate articles and their relevant citations. While resection can often achieve favorable outcomes in the treatment of spinal ependymoma, more research on the unique molecular, genetic, chromosomal and epigenetic traits must be conducted in order to tailor treatment and intervention for those patients for whom total resection is not possible.
    Clinical neurology and neurosurgery 12/2015; 139:210-215. DOI:10.1016/j.clineuro.2015.10.011
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    ABSTRACT: Objective: traumatic neuroma is a pathological condition of peripheral nervous system consisting of localized proliferation of injured nerve elements. The symptoms depend on the type of involved nerve (motor and/or sensitive) and on the site and the extension of the lesion. Ultrasound is the best tool to depict the morphology of nerve, especially in traumatic conditions. We present a study aimed to assess the correlation between the degree of nerve function and the ultrasound morphology of neuromas. Patients and methods: we retrospectively evaluated 18 patients with neuromas (not transected) occurred after a closed nerve trauma evaluated with clinical and ultrasound assessment. The clinical evaluation was related to the % of increase of cross sectional area as detected by nerve ultrasound respect to normal nerve. Results: we observed that dimensions of neuromas are not related to function until neuroma have cross sectional area 5 times enlarged respect to normal nerve, in this case recovery never occurs. Conclusion: our study failed to clear detect a relation between cross sectional area enlargement of neuroma and nerve function, but showed a cut off beyond which prognosis is negative. This result provide some useful information for prognosis, nevertheless we believe that future perspective studies are needed to better understand the timing of developing neuromas and its evolution.
    Clinical neurology and neurosurgery 11/2015; 139:314-318. DOI:10.1016/j.clineuro.2015.10.034
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    ABSTRACT: An elderly gentleman presented with acute onset of bilateral visual blurring and generalized headache after 1week post electrocution injury. Clinically, the symptoms were attributed to cortical lesion. Magnetic resonance imaging (MRI) of brain revealed bilaterally symmetrical diffusion restriction in parietal and occipital areas. Treatment with intravenous steroids resulted in remarkable improvement in symptoms. Neurological injury secondary to electrocution is a well described entity having a variety of clinical presentation. We put forward our experience with this unique case presenting as post electrocution delayed onset of visual symptoms. Discussion and review of literature related to this clinical entity will also be presented.
    Clinical neurology and neurosurgery 11/2015; 139:311-313. DOI:10.1016/j.clineuro.2015.10.015
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    ABSTRACT: Objective: To investigate the correlation between the kyphosis angle of injured vertebral body and the risk of upper adjacent vertebral fracture after percutaneous kyphoplasty (PKP) using an osteoporotic vertebral compressed fracture model. Materials and methods: 24 functional spinal units (FSUs, T9 to L4) were selected from 6 elderly formalin preserved vertebral specimens to build the vertebral compressed fracture model. According to the kyphosis angle between the upper plate of upper vertebral body and the horizontal plane, group A (0°) and group B (20°) were defined, with each group comprised with 12 FSUs. The stiffness and fracture load were measured in both groups. Results: After PKP, the stiffness was (571.513±83.373)N/mm and the fracture load was (1751.659±112.291)N in group A, with both significantly higher than those of group B (stiffness, (307.706±46.723)N/mm; fracture load, (1128.011±125.417)N). Conclusions: To reduce the risk of upper adjacent vertebral fracture, it is better to restore the height of injured vertebral body and decrease the angle of kyphosis to increase the capability of upper adjacent vertebral body against fracture.
    Clinical neurology and neurosurgery 11/2015; 139:272-277. DOI:10.1016/j.clineuro.2015.10.026
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    ABSTRACT: Objective: To assess the association between juxta-facet-joint cysts (JFC) occurrence at the lumbar spine and Facet Joint (FJ) orientation, -tropism and -arthritis. Methods: Study group, 36 consecutive patients with JFC and the same number of controls, with degenerative diseases without JFC were match paired for demographics and spine segment. Parameter assessment was by T2-weighted axial MRI scans. JFC diagnosis was confirmed histopathologically. Group comparison was by Student's t-test for continuous variables and X(2) for categorical variables. Results: Nineteen female and 17 male patients, aged between 45 and 85 years (mean 67.19±10.3 years) had a mean JFC size of 9.26±4.8mm occurring most frequently in the segment L4-L5 (75% n=25) and on the left side (61%). Mean FJ orientation of the study group was significantly more coronal compared to controls (left side 42° vs 36°, p<0.02*, 95% confidence interval: 0.9-11.5 and right side 43° vs 37°, p<0.02*, 95% confidence interval: 0.6-10.6 respectively). However, individual intersegmental analysis for study group patients showed the JFC bearing side to be significantly more sagittally oriented 40°±11.2° compared to 45°±13.2° for the side without FJC (p<0.03*, 95% confidence interval: 8.1-1.7). 50% of the study group showed FJ asymmetry compared to 30% in controls, with a trend for FJ tropism (p<0.07). Severe (grade 3) FJ arthritis was significantly more predominant in the study group 23/33 (p<0.001*) as compared to controls. Conclusions: Compared to a control group, JFC occurrence is associated with significant higher rates of arthritis and coronally orientated FJ. At intersegment comparison within the same patient cysts located in more sagittally orientated FJ and the asymmetric segments show a trend for FJ tropism.
    Clinical neurology and neurosurgery 11/2015; 139:278-281. DOI:10.1016/j.clineuro.2015.10.030
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    ABSTRACT: Background: Congenital trochlear palsy may manifest with sudden vertical diplopia due to decompensation during the later life, which may bring a diagnostic challenge. Case presentation: Two men with vertical diplopia for several years after age of 50 were referred with persisting or suddenly aggravating diplopia. Findings were consistent with unilateral superior oblique palsy (SOP) in both patients with a contraversive head tilt. Facial asymmetry was suggestive of a congenital cause in a patient. High resolution magnetic resonance image (MRI)s disclosed atrophic superior oblique and absent trochlear nerve in the side of SOP in both patients. Conclusion: Imaging demonstration of superior oblique atrophy and absent trochlear nerve may aid in diagnosis of congenital SOP presenting sudden vertical diplopia during the later life due to delayed decompensation.
    Clinical neurology and neurosurgery 11/2015; 139:269-271. DOI:10.1016/j.clineuro.2015.10.027
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    ABSTRACT: Objectives: Since the turn of the century, minimally invasive surgery has become increasingly widespread. Discectomy surgery has evolved from wide open to microscopic and now endoscopic. This study aims to demonstrate that transforaminal endoscopic discectomy is an alternative and safe approach for degenerative disk surgery. Patients and methods: Two year retrospective assessments of patients who underwent transforaminal endoscopic discectomy at a tertiary neurosurgical center in the United Kingdom by a single surgeon. Under strict confidentiality, data was collected from online patient data and PACS systems. Patient feedback was achieved using phone call follow up and clinic appointments. Standard statistical analysis was performed. Results: 201 patients had endoscopic discectomy and the mean age was 41 years. Male:female ratio was 1.3:1.0. Mean time of onset of symptoms was 5.5 months and the most common level was L4/5 (53%). All endoscopic discectomies were performed under local anesthesia. Theater time was on average 110min. 10 patients were lost to follow up. 95% of patients were discharged within 7h post operatively. Visual acuity score of the pain dropped from an average of 7/10 pre-operatively to 0-1/10 in 95% of patients two weeks post operatively. 87% patients went back to their normal daily activities within two weeks. There were no cases of CSF leak, hematoma formation or wound infection. 1% of patients developed a nerve root injury. 6% of patients had recurrent herniation and require microdiscectomy. Conclusion: Endoscopic discectomy can be an alternative approach to microdiscectomy. While it can take more expertise to perform endoscopic discectomy, our data shows that the far lateral endoscopic discectomy using the TESSYS technique has comparable outcomes to microdiscectomy.
    Clinical neurology and neurosurgery 11/2015; 139. DOI:10.1016/j.clineuro.2015.11.001
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    ABSTRACT: Objectives: Postoperative meningitis is a serious complication occurring after neurosurgical interventions. However, few investigations have focused specifically on the risk factors that predispose patients to meningitis after major craniotomy. This study identified the risk factors for postoperative meningitis after neurovascular surgery, and investigated the relationship between postoperative meningitis and clinical outcome. Patients and methods: A total of 148 consecutive patients with subarachnoid hemorrhage (SAH) who underwent clipping surgery through a pterional approach within 72h between January 2007 and September 2011 were retrospectively analyzed. The treatment strategy of our hospital for patients with SAH was based on the findings of digital subtraction angiography in the acute phase. Coil embolization was firstly considered, and clipping through craniotomy if indicated was performed as soon as possible. Prophylactic antibiotics were administered before beginning craniotomy and for at least 3 days after. Hydrocortisone was used to prevent hyponatremia if allowed by the medical condition of the patient. Intrathecal administration of nicardipine hydrochloride was given if required for vasospasm treatment. Meningitis was clinically diagnosed from the blood samplings and cerebrospinal fluid (CSF) examinations. Data were collected from the electronic and paper charts. The status of modified Rankin scale (mRS) 0-2 at discharge was defined as favorable outcome. Results: A total of 14 patients (9.5%) had meningitis during this study period. Symptomatic vasospasm was detected in 33 patients (22.3%), and 12 patients (8.1%) had permanent neurological deficits caused by vasospasm. Overall, 109 patients (73.6%) had favorable outcome. The longer duration of drainage placement, presence of CSF leakage, and intrathecal administration of vasodilatory agent showed significantly higher incidence of postoperative meningitis in univariate analysis (p=0.0093, 0.0017, and 0.0090, respectively). The proportion of favorable outcome patients at discharge (mRS 0-2) was significantly lower in patients with postoperative meningitis (35.7%) than in patients without it (77.6%) (p=0.0004). The duration of in-hospital stay was significantly longer in patients with postoperative meningitis (median 58.5, range 28-115 days) than in patients without it (median 38.5, range 19-149 days) (p<0.001). Multivariate logistic regression analysis showed that only presence of CSF leakage was associated with postoperative meningitis (p=0.0299). Conclusion: Meningitis after surgery is still a serious complication that requires preventative intervention. The clinical outcome of patients with postoperative meningitis after neurovascular surgery is not still satisfactory.
    Clinical neurology and neurosurgery 11/2015; 139. DOI:10.1016/j.clineuro.2015.10.029
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    ABSTRACT: Objective: [(11)C] methionine (MET) positron-emission tomography (PET) is a useful diagnostic and therapeutic tool in neuro-oncology. The aim of this study was to evaluate the relationship between MET uptake and the histopathological grade in both primary brain tumours and brain metastases. A secondary goal was to assess the relationship between MET uptake and patients' survival after surgery. Methods: We reviewed a consecutive series of 43 PET studies performed at our institution. Out of the 43 patients studied, 35 harboured primary brain tumours (3 grade I, 12 grade II, 7 grade III and 13 grade IV) and 8 patients had brain metastases. We measured the tumour/cortex ratio (T/C ratio) on each PET study and we investigated the correlations among the tracer uptake, tumour grade, tumour type, MRI parameters and outcome. Results: The mean T/C ratio was 1.8±0.9 for benign lesions and low grade gliomas (grade I and II) and 2.7±1 for high grade gliomas (grade III and IV). In brain metastases it was 2.5±0.7, with a significant difference in MET uptake between low and high grades gliomas (P=0.03). There was no statistically significant difference among all different histologic types. We found that both contrast enhancement and perfusion studies correlate with MET uptake in brain tumours. Moreover, in Kaplan-Meier curves, the T/C ratio adversely affects long term survival in patients with brain tumours (P=0.01). Conclusions: MET PET appears to be useful in diagnosis and evaluation of potential malignancy in brain tumours. MET uptake is also related with the overall survival in patients with brain tumours. Nevertheless, further studies are needed in order to define its possible clinical implications in identifying patients at high risk of tumour progression or resistance to therapy.
    Clinical neurology and neurosurgery 11/2015; 139. DOI:10.1016/j.clineuro.2015.10.035

  • Clinical neurology and neurosurgery 11/2015; DOI:10.1016/j.clineuro.2015.10.009
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    ABSTRACT: Study design: A retrospective study. Objective: To clarify the predictors of the operation results for ossification of the posterior longitudinal ligament (OPLL). Summary of background data: Detailed analyses of surgical outcomes of OPLL have been rare because most survey aimed to investigate cervical spondylotic myelopathy. Methods: All patients who underwent cervical operation for OPLL between January 2011 and December 2011 were included in this analysis. We investigated the patients' characteristics and surgical approaches, and compared the radiographical characteristics of OPLL. Results: The mean mJOA score improved from 8.312±3.021 points preoperatively to 11.24±3.43 points at 24 months after operation (P<0.001). The average change in mJOA score was significantly greater in patients with a higher Nirik score than in those with lower Nirik scores (P<0.0001). The average change in mJOA score was also significantly different in patients with trauma history (P<0.0001). The average recovery ratio was 42±26.3% in young patients and 30±31.6% in the group older than 50 years (P=0.012). The average recovery ratio in patients with acute and chronic symptoms was 48±22.9% and 26±33.9%, respectively. There was great difference between the two groups. Conclusion: OPLL patients with myelopathy would receive good result after the operation. Age and symptom duration are related to the surgical outcomes. Patients with lower Nirick grade and without trauma history would receive better results before and after the operation.
    Clinical neurology and neurosurgery 11/2015; 139. DOI:10.1016/j.clineuro.2015.10.031
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    ABSTRACT: Objective: Membrane stabilizing agents (MSAs) improves function and reduces neuropathic pain in a subset of patients with LSS. No study has investigated the pre-treatment demographic and psychosocial factors associated with quality of life (QOL) outcomes following the use of MSAs. In this study we sought to create prediction models for post-treatment outcome. Methods: All patients who were diagnosed with LSS and treated with MSAs at a single institution between September 2010 and March 2013 were retrospectively reviewed. QOL outcomes were collected prospectively. Prediction tools were created using multivariable logistic regression and Cox proportional hazard models. Outcome measures were: 1 - need for surgery within 1 year after initiating MSA treatment, 2 - time until surgery after initiating MSA treatment, 3 - any improvement in EuroQol (EQ)-5D QOL index, 4 - improvement in EQ-5D index exceeding the minimum clinically important difference (MCID). Results: 1346 patients were included. For goal 1 (need for surgery), the prediction model was less robust. For goal 2 (time to surgery), only age was a significant predictor, with each 10-year increase in age causing the hazard of eventually having surgery to increase by 20%. 382 patients were available for analysis for goals 3 and 4 (predicting improvement in EQ-5D). Prediction models for these goals were good with C-statistics 0.73 and 0.85, respectively. Predictive factors for superior outcomes included lower baseline EQ-5D index (worse QOL), less baseline depression, greater median income, and being married. Conclusion: MSA treatment provides improvements in quality of life for those individuals with LSS. Treatment effects of MSAs will be greatest in those with worse quality of life, less depression, married patients, and those of higher socio-economic status.
    Clinical neurology and neurosurgery 10/2015; 139:234-240. DOI:10.1016/j.clineuro.2015.10.018
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    ABSTRACT: Carpal tunnel syndrome (CTS) is probably associated with diabetes mellitus, but its link to prediabetes (PD) is unknown. To determine prevalence of PD and others risk factors in CTS. A cross-sectional study including 115 idiopathic CTS patients and 115 age-, gender-and body mass index (BMI)-matched controls was performed. Clinical, laboratory and neurophysiological evaluations were conducted in all subjects to confirm CTS diagnosis. CTS severity was graded on a standardized neurophysiological scale. PD was defined using strict criteria. The prevalence of PD was similar in CTS and control groups (27% vs. 21.7%, respectively P=0.44). Nocturnal symptoms (91.3%) and moderate CTS (58.3%) were most frequently observed in CTS patients. In logistic regression analysis, PD was significantly correlated with age (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.01-1.09; P=0.006) and BMI (OR 1.08. 95% CI 1.01-1.16; P=0.026), but not with CTS (OR 0.82, 95% CI 0.43-1.53; P=0.537). CTS patients with PD had a significantly higher mean age compared to those without PD (53.8±10.2 vs. 49.5±8.6 years, respectively P=0.027). The frequency of age >60 years was significantly higher in CTS with PD than in CTS without PD (29.0% vs. 8.3%, respectively P=0.04) as was BMI >30kg/m(2) (64.5% vs. 33.3%, respectively P=0.03). No significant differences were observed between the two CTS groups with respect to gender, BMI, symptoms, and neurophysiological severity of CTS. Our findings indicated that CTS is not associated with PD, but that PD is closely linked to age and overweight. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical neurology and neurosurgery 10/2015; 137. DOI:10.1016/j.clineuro.2015.06.015
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    ABSTRACT: Here we present a review of the pathophysiology of tobacco smoking on intracranial aneurysms, self-reported smoking status in these patients, screening tools and assays available for assessing active nicotine use, means of impacting smoking cessation rates, and the potential impact of smoking cessation on risk of rupture and recurrence of treated intracranial aneurysms. A literature search using PubMed was done to identify all English language studies relating to tobacco use and intracranial aneurysms, smoking and subarachnoid hemorrhage, nicotine breakdown products, and smoking cessation in neurosurgery. Results from the studies were reviewed and summarized. Tobacco use is an independent risk factor for formation, growth, and rupture of intracranial aneurysms. The pathogenesis of aneurysm formation is complex, and related to increased wall shear stress, endothelial dysfunction, atherosclerosis, and altered gene regulation. Furthermore 80% of all aneurysmal ruptures occur in patients who have used tobacco products. It is suboptimal to rely on self-reported smoking status in order to determine patient risk. Use of objective metrics for ongoing tobacco use may be indicated in selected patients, and may increase smoking cessation rates in these patients. A variety of laboratory and point-of-care tests are available for measurement of nicotine and nicotine breakdown products. Most assays in clinical practice measure the nicotine breakdown product cotinine, which constitutes 75% of nicotine metabolites excreted in the urine and has a substantial half-life of 16h, compared to nicotine's 2-h half-life. With proper identification, an astute physician may be able to assist in smoking cessation and foster improved patient care. By following recommended guidelines and prescribing pharmaceutical aid, a patient has a 2.5 times greater chance of smoking cessation compared with attempting to stop without physician assistance. Smoking increases risk for intracranial aneurysm formation, rupture, re-rupture and need for re-treatment. Measurement of nicotine breakdown products may have clinical utility in the management of patients with intracranial aneurysms. Smoking cessation interventions may be effective, and use of established smoking cessation tools use may lead to improved clinical outcomes in these patients. The effects of smoking cessation efforts on smoking cessation and intracranial aneurysm outcomes is a fertile field for future investigation. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical neurology and neurosurgery 10/2015; 137. DOI:10.1016/j.clineuro.2015.06.016

  • Clinical neurology and neurosurgery 10/2015; 139:241-243. DOI:10.1016/j.clineuro.2015.10.021
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    ABSTRACT: Objective: Recurrent Guillain-Barré syndrome (rGBS) has been described as a rare entity with distinct characteristics. However, little is known about rGBS in Asian group. The aim of this study was to identify the incidence and clinical course of rGBS, and to determine its clinical/pathophysiological implications. Methods: The consecutive data of 117 GBS patients were retrieved from a single university-based hospital in Korea and analyzed in terms of clinical, serological, electrophysiological aspects. Results: A thorough review revealed that three (2.6%) of the enrolled patients had experienced more than two definite recurrent attacks of GBS. Interestingly, all three cases exhibited clinically stereotypical features, serum antiganglioside antibodies, and rapid recovery after intravenous immunoglobulin treatment. Clinical, serological, and electrophysiological features of rGBS cases were described in detail. Conclusion: The stereotypic presentation of each attack in this variant suggests the importance of both host and genetic factors for the clinical manifestations. In addition, the simultaneous presence of serum antiganglioside antibodies and rapid recovery implicate reversible nerve conduction failure as the mechanism of rGBS. These features are different from typical monophasic GBS and acute onset of chronic inflammatory demyelinating polyneuropathy.
    Clinical neurology and neurosurgery 10/2015; 139:230-233. DOI:10.1016/j.clineuro.2015.10.022

  • Clinical neurology and neurosurgery 10/2015; 139:247. DOI:10.1016/j.clineuro.2015.09.014

  • Clinical neurology and neurosurgery 10/2015; 139:221-223. DOI:10.1016/j.clineuro.2015.10.020