Clinical neurology and neurosurgery Journal Impact Factor & Information

Publisher: Elsevier

Journal description

Current impact factor: 1.25

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 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 1.58
Cited half-life 5.50
Immediacy index 0.23
Eigenfactor 0.01
Article influence 0.43
ISSN 1872-6968

Publisher details


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Pre-print allowed on any website or open access repository
    • Voluntary deposit by author of authors post-print allowed on authors' personal website, or institutions open scholarly website including Institutional Repository, without embargo, where there is not a policy or mandate
    • Deposit due to Funding Body, Institutional and Governmental policy or mandate only allowed where separate agreement between repository and the publisher exists.
    • 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 .
    • Set statement to accompany deposit
    • Published source must be acknowledged
    • Must link to journal home page or articles' DOI
    • Publisher's version/PDF cannot be used
    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PubMed Central after 12 months
    • Publisher last contacted on 18/10/2013
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Rheumatoid patients may develop a retrodental lesion (atlantoaxial rheumatoid pannus) that may cause cervical instability and/or neurological compromise. The objective is to characterize clinical and radiographic outcomes after posterior instrumented fusion for atlantoaxial rheumatoid pannus. We retrospectively reviewed all patients who underwent posterior fusions for an atlantoaxial rheumatoid pannus at a single institution. Both preoperative and postoperative imaging was available for all patients. Anterior or circumferential operations, non-atlantoaxial panni, or prior C1-C2 operations were excluded. Primary outcome measures included Nurick score, Ranawat score (neurologic status in patients with rheumatoid arthritis), pannus regression, and reoperation. Pannus volume was determined with axial and sagittal views on both preoperative and postoperative radiological images. Thirty patients surgically managed for an atlantoaxial rheumatoid pannus were followed for a mean of 24.43 months. Nine patients underwent posterior instrumented fusion alone, while 21 patients underwent posterior decompression and instrumented fusion. Following a posterior instrumented fusion in all 30 patients, the pannus statistically significantly regressed by 44.44%, from a mean volume of 1.26cm(3) to 0.70cm(3) (p<0.001), over 8.02 months. The Nurick score significantly improved from 2.40 to 0.60 (p<0.001), but the marginal improvement of 0.20 in the Ranawat score did not reach significance (p=0.312). Six patients (20%) required reoperations over a mean of 13.18 months. Reoperations were indicated for C1 instrumentation failure in four patients and pseudoarthrosis in two patients. Following posterior instrumented fusion, the pannus radiographically regressed by 44.44% over a mean of 8.02 months, and patients clinically improved per the Nurick score. The Ranawat score did not improve, and 20% of patients required reoperation over a mean of 13.18 months. The annualized reoperation rate was approximately 13.62%. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical neurology and neurosurgery 10/2015; 137. DOI:10.1016/j.clineuro.2015.06.010
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    ABSTRACT: Tumour resection in the Rolandic region is a challenge. Aim of this study is to review a series of patients malignant glioma surgery in the Rolandic region which was performed by combinations of neuronavigation, sonography, 5-aminolevulinic acid fluorescence guided (5-ALA) surgery and intraoperative electrophysiological monitoring (IOM). 29 patients suffering malignant gliomas in the motor cortex (17) and sensory cortex (12) were analyzed with respect to functional outcome and grade of resections. Improvement of motor function was seen in 41.5% one week after surgery, 41.5% were stable, only 17% deteriorated. After three months patients had an improvement of motor function in 56%, of Karnofsky Score (KPS) 27% and sensory function was improved in 8%. Deterioration of motor function was seen in 16%, in sensory function 4% and in KPS 28% after three months. 25% showed no residual tumour in early post surgical contrast enhanced MRI. 10% had less than 2% residual tumour and 15% had 2-5% residual tumour. Preoperative functional neuroimaging, neuronavigation for planning the surgical approach and resection margins, intraoperative sonography and 5-ALA guided surgery in combination with the application of IOM shows that functional outcome and total to subtotal resection of malignant glioma in the Rolandic region is feasible. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical neurology and neurosurgery 09/2015; 136. DOI:10.1016/j.clineuro.2015.05.021
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    ABSTRACT: Anterior cervical discectomy and fusion (ACDF) is an accepted technique for the management of cervical spinal degenerative disease. Recently, new resorbable materials have been proposed for the anterior cervical fusion to eliminate some of the disadvantages and complications of metal plates. The aim of our study was to evaluate the long-term clinical results of the ACDF implants made out of bioabsorbable materials. We performed a retrospective descriptive study of a series of 17 ACDF patients operated with the Inion S-1™ resorbable screws and plates (made out of biodegradable copolymers composed of l-lactic acid and d,l-lactic acid 80/20) 5-7 years ago. The mean age of the patients was 45 years. A single-level procedure was carried out in 13 patients and a double-level procedure in four patients, and the most commonly fused level was C5-C6. Clinical background, preoperative and postoperative symptoms, previous trauma, complications, radiographic fusion and condition of the prevertebral space (preoperative and postoperative) were analyzed. We observed a good fusion rate and stability using resorbable plates and screws. None of the patients had associated severe complications such as adjacent tissue edema or infection, or had to be reoperated due to failure or migration of the used implants. The results of this retrospective clinical long-term follow up demonstrate that cervical fusion can be successfully achieved using resorbable implants. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical neurology and neurosurgery 09/2015; 136. DOI:10.1016/j.clineuro.2015.04.002
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    ABSTRACT: We report a case of Huntington's disease (HD) in a 53-year-old male with multiple sclerosis (MS). The diagnosis of MS met the McDonald criteria and was based on clinical attacks separated in space and time, cerebrospinal fluid, and MRI. The diagnosis of HD was established by DNA testing, family history, and positron emission tomography. While a number of neurologic and autoimmune diseases have been reported with MS, this is the first co-occurrence of HD and MS. Salient features of both disorders are reviewed as well as the importance of obtaining a thorough family history. Published by Elsevier B.V.
    Clinical neurology and neurosurgery 09/2015; 136. DOI:10.1016/j.clineuro.2015.05.006
  • Clinical neurology and neurosurgery 09/2015; 136. DOI:10.1016/j.clineuro.2015.05.009
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    ABSTRACT: A retrospective study was conducted to compare clinical outcome with radiographic data and clinical complications between isobar posterior dynamic stabilization (IPDS, Scient'x, France) and posterior lumbar inter-body fusion (PLIF) for lumbar degenerative disease. 113 consecutive patients (IPDS group, N=62; PLIF group, N=51) with lumbar degenerative disease were operated on between March 2009 and November 2011. Patient charts, radiographic films and medical records were reviewed. Clinical outcomes including the visual analog scale (VAS), Oswestry disability index (ODI) scores, and radiographic outcomes, including disk height index (DHI) and range of motion (ROM) were retrospectively analyzed. The ODI and VAS leg and back pain scores in two groups were significantly improved at 6 and, 24 months and at the final follow-up (all, P<0.05). The degree of improvements in the ODI and VAS back pain scores, the incidence of complications and the rate of adjacent segment degeneration were similar in both groups (P>0.05). However, operation times and blood loss were significantly reduced in the IPDS group (P<0.05). In summary, with similar symptoms improvement and complication rates, the results of this study demonstrate that IPDS is an effective and safe treatment for lumbar degenerative disease. There is currently insufficient evidence to indicate that the IPDS can avoid adjacent segment degeneration therefore, it is essential to conduct prospective, randomized, controlled multicenter studies with larger sample size and longer follow-up. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical neurology and neurosurgery 09/2015; 136. DOI:10.1016/j.clineuro.2015.06.003
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    ABSTRACT: Lower motor neuron disease (LMND) is the term generally used to describe diseases in which only lower motor neuron signs are detected. A snake eyes appearance on magnetic resonance imaging (MRI) is associated with a wide spectrum of neurological conditions including LMND. The author reports on three unique LMND patients with upper limb muscle weakness and atrophy who show a snake eyes appearance by MRI. The patients were aged 18, 40 and 52 years, respectively, at the onset of the disease and had a longstanding clinical course (more than 10 years for two patients and 8 years for one patient). They were followed up for more than 6 years. Clinical manifestations were characterized by (1) longstanding slow progression or delayed spontaneous arrest of asymmetric lower motor neuron signs localized exclusively in the upper extremities with unilateral predominance and distal or proximal preponderance; (2) the absence of upper motor neuron signs, bulbar signs, sensory disturbances and respiratory involvement; (3) a snake eyes appearance on the anterior horns of the cervical cord over more than 3 vertebrae by axial T2-weighted MRI and a longitudinal linear-shaped T2-signal hyperintensity by sagittal MRI; (4) neurogenic change with fasciculation and denervation potentials (fibrillation and a positive sharp wave) confined to the affected muscles by needle electromyogram; and (5) normal cerebrospinal fluid and a normal creatine kinase level. These cases did not fall into any existing category of LMND, such as progressive muscular atrophy, flail arm syndrome or Hirayama disease. These patients should be classified as sporadic LMND with snake eyes on MRI with a relatively benign prognosis. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical neurology and neurosurgery 09/2015; 136. DOI:10.1016/j.clineuro.2015.06.006
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    ABSTRACT: Axonal loss is the cause of permanent neurologic disability in patients with MS. There are a lot of candidates to be a surrogate biological marker of the axonal loss in MS including tau protein. In the present study, we aimed to assess the levels of the tau protein in patients with MS, and in neurologically healthy controls. We included 41 patients with MS (32 RRMS, 9 SPMS) in this study. All the patients with MS were in an attack period. Control group was consist of 18 neurologically healty patients who underwent spinal anesthesia for orthopedic operations. The CSF tau protein level was measured by double antibody sandwich ELİSA. The patients with RRMS had a higher tau protein level than the patients with SPMS and the control group. The patients with SPMS had a lower tau protein level than the control group. High levels of tau protein in the CSF of RRMS patients in an attack period may indicate ongoing axonal transection owing to inflammation. Due to the brain atrophy, the patients with SPMS have less neurons to produce tau protein. The low levels of tau protein in the CSF of SPMS patients may denote axonal degeneration. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical neurology and neurosurgery 09/2015; 136. DOI:10.1016/j.clineuro.2015.05.030
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    ABSTRACT: Cranioplasty is considered as a routine procedure in everyday neurosurgical practice for the patient with cranial defect, however, there is no established consensus on optimal surgical timing. To compare the effect of early cranioplasty (1-3 months after DC) and late cranioplasty (3-6 months after DC) on the complications and recovery of neurological function in the management of patients who received decompressive craniotomy. In this paper, the authors report a systematic review and meta-analysis of operative time, complications and neurological function outcomes on different timing of cranioplasty. Randomized or non-randomized controlled trials of early cranioplasty and late cranioplasty surgery were considered for inclusion. Nine published reports of eligible studies involving 1209 participants meet the inclusion criteria. Compared with late cranioplasty, early cranioplasty had no significant difference in overall complications [RR=1.14, 95%CI (0.83, 1.55), p>0.05], infection rates [RR=0.87, 95%CI (0.47, 1.61), p>0.05], intracranial hematoma [RR=1.09, 95%CI (0.53, 2.25), p>0.05]; subdural fluid collection [RR=0.47, 95%CI (0.15, 1.41), p>0.05]. However, early CP significantly reduced the duration of cranioplasty [mean difference=-13.46, 95%CI (-21.26, 5.67), p<0.05]. The postoperative hydrocephalus rates were significant higher in the early cranioplasty group [RR=2.67, 95%CI (1.24, 5.73), p<0.05]. Early CP can only reduce the duration of operation, but cannot reduce the complications of patients and even increase the risk of hydrocephalus. More evidence from advanced multi-center studies is needed to provide illumination for the timing selection of CP surgery. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical neurology and neurosurgery 09/2015; 136. DOI:10.1016/j.clineuro.2015.05.031
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    ABSTRACT: Many medical school metrics are used by residency programs to differentiate residency applicants. The importance of each metric in the field of neurology is unclear. This is a single-site retrospective evaluation of characteristics that predict resident quality. Several measures from all 57 adult neurology residents over 8 years were obtained including Step I scores, college and medical school rankings, in-service training examination scores, advanced degrees, and number of publications during residency. Two program directors, blinded to these data and each other's ratings, rated the quality of all residents at the end of the residency. The data were then anonymized for all analyses. There was no significant relationship between Step I scores and resident quality, though Step I scores correlated significantly with in-service training examination scores. Medical students with PhDs did not perform differently in terms of resident quality, number of publications in residency, or in-service training examination scores. Resident quality was correlated with the ranking of each applicant's undergraduate college, but not the ranking of their medical school. While Step I is used by many residency programs in ranking potential residents, it does not correlate with overall resident quality, although Step I scores may predict success on future standardized medical examinations. Students with PhDs do not differ from other residents across several metrics. Applicants from highly selective colleges, though not highly selective medical schools, had significantly higher quality ratings. Further research is needed to determine characteristics of medical students that predict performance during neurology residency. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical neurology and neurosurgery 08/2015; 135. DOI:10.1016/j.clineuro.2015.05.007
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    ABSTRACT: The logistics involved in administration of IV tPA for acute ischemic stroke patients are complex, and may contribute to variability in door-to-needle times between different hospitals. We sought to identify practice patterns in stroke centers related to IV tPA use. We hypothesized that there would be significant variability in logistics related to ancillary staff (i.e. nursing, pharmacists) processes in the emergency room setting. A 21 question survey was distributed to attendees of the AHA/ASA Southwest Affiliate Stroke Coordinators Conference to evaluate potential barriers and delays with regards to thrombolysis for acute strokes patients in the Emergency Department setting. Answers were anonymous and aggregated to examine trends in responses. Responses were obtained from 37 of 67 (55%) stroke centers, which were located mainly in the Southwest United States. Logistical processes differed between facilities. Nursing and pharmacy carried stroke pagers in only 19% of the centers, and pharmacy responded to stroke alerts only one-third of centers. Insertion of Foley catheters and nasogastric tubes prior to tPA was routine in some of the sites. Other barriers to IV tPA administration included physician reluctance and inadequate communication between health care providers. Practices regarding logistics for giving IV tPA may be variable amongst different stroke centers. Given this potential variability, prospective evaluation to confirm these preliminary findings is warranted. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical neurology and neurosurgery 08/2015; 135. DOI:10.1016/j.clineuro.2015.04.027
  • Clinical neurology and neurosurgery 08/2015; 135. DOI:10.1016/j.clineuro.2015.05.012
  • Clinical neurology and neurosurgery 08/2015; 135. DOI:10.1016/j.clineuro.2015.05.011
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    ABSTRACT: To study the feasibility and safety of transradial artery access for endovascular intervention of severe intracranial vertebrobasilar stenosis for selected patients not suitable for transfemoral access. This was a retrospective analysis of 58 patients who had undergone intervention for severe intracranial vertebrobasilar stenosis using transradial access between January 2012 and September 2014. The reasons for transradial access were traced. The outcome measures were the technical success rate, 30-day stroke or death in the territory of the culprit artery, periprocedural and access site complication rates. Out of the 58 patients, 19 patients (32.8%) used the transradial approach due to poor iliofemoral artery access, 28 (48.3%) due to unfavorable brachiocephalic or subclavian artery anatomy, 11 (19%) due to unfavorable vertebral artery anatomy. The technical success rate was 100%. There were four periprocedural complications, one of which was asymptomatic. The 30-day stroke rate was 5.2% (3/58 patients), with two of them having no residual neurological deficits. There was no mortality. None had access site complications. For selected patients with severe intracranial vertebrobasilar stenosis with difficult femoral access or anatomical variations precluding provision of a stable support for intracranial intervention, the transradial approach was shown to be a safe and feasible alternative route of access. Future trials of endovascular treatment for intracranial posterior circulation strokes should take into account the route of access. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical neurology and neurosurgery 07/2015; 134. DOI:10.1016/j.clineuro.2015.04.015
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    ABSTRACT: The 9-item Wearing-off Questionnaire (WOQ-9) is a useful tool for screening of wearing-off. We performed a validation study of the Japanese version of the WOQ-9 (JWOQ-9) using a cross-sectional design in Japanese Parkinson's disease (PD) patients diagnosed with sporadic PD and treated with levodopa. Subjects with severe dementia, uncontrolled psychiatric comorbidities, and previous PD neurosurgery were excluded. The wearing-off phenomenon was detected according to the JWOQ-9, and the results were compared with independent evaluations of wearing-off conducted by PD specialists blinded to the JWOQ-9 results. To validate the JWOQ-9, a sample size of at least 70 patients with wearing-off and 70 patients without wearing-off was required. Therefore, a total of 180 patients (101 patients with wearing-off and 79 patients without wearing-off) were enrolled. The sensitivity, specificity, positive predictive value, and negative predictive value of the JWOQ-9 were 94.1%, 39.2%, 66.4%, and 83.8%, respectively. Motor symptom questions demonstrated both moderate sensitivity (58.1-87.3%) and specificity (60.4-87.5%). In contrast, non-motor symptom questions demonstrated fair to moderate sensitivity (51.5-64.6%), with high specificity (80.0-94.1%). Like the original WOQ-9, the JWOQ-9 exhibits significant value for detecting possible wearing-off. The JWOQ-9 is a useful screening tool for detecting wearing-off of both motor and non-motor symptoms. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical neurology and neurosurgery 07/2015; 134. DOI:10.1016/j.clineuro.2015.04.021
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    ABSTRACT: Minimally invasive craniopuncture has been used to treat intracerebral hemorrhage (ICH) for over 20 years in China. However, one-off total evacuation of hematoma cannot be achieved through this procedure because it is not an open surgery. This study is designed to identify factors that can increase the hematoma evacuation rate (ER) of this procedure and to evaluate the influence of ER on long-term outcome. A total of 309 patients with basal ganglia ICH treated by minimally invasive craniopuncture were analyzed retrospectively. Univariate and multivariate linear regression analyses were used to identify factors correlated with a high ER. The correlation between ER and long-term outcome was also analyzed by logistic regression and the Spearman correlation. A low hematoma mean CT number (β=-0.773, p<0.001) and postoperative cerebrospinal fluid (CSF) outflow (β=0.193, p<0.001) were found to be independent factors associated with a high ER. In patients with 30-50ml of hematoma, a high ER was correlated with a high Barthel index improvement (r=0.611, p<0.001) and a high modified Rankin scale decline (r=0.517, p<0.001). In patients with 50-80ml of hematoma, a high ER was a protective factor of case fatality (B=-2.297, p=0.005). The hematoma mean CT number can predict the efficiency of minimally invasive craniopuncture in patients with ICH. In patients with ventricular involvement, the tip of the puncture needle should be placed close to the tear in the ventricle rather than at the center of the hematoma to facilitate postoperative CSF outflow. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical neurology and neurosurgery 07/2015; 134. DOI:10.1016/j.clineuro.2015.04.020