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Research Article | DOI: https://doi.org/10.31579/2641-0419/538
1Emergency department, Yaounde Emergency Center
2Wayne state university School of Medicine, Internal medicine department
3Liberty University School of Medicine Virginia, United State of America
4Tulane University School of Medicine, Inetrnal medicine/ Cardiology department
5Garden City Hospital Internal Medicine/Cardiology department
*Corresponding Author: Aubin Sandio, Wayne state university School of Medicine, Internal medicine department.
Citation: Fleury Bolla, Aubin Sandio, Lady Di Ayong, Serge Gouatna, Ludovic Tchounja, et al, (2026), Analysis of Age distribution at Onset Across Stroke Subtypes in developing countries: A comparative study on Later Presentation of Cerebral Hemorrhage, J Clinical Cardiology and Cardiovascular Interventions, 9(2); DOI:10.31579/2641-0419/538
Copyright: © 2026, Fleury Bolla. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 01 December 2025 | Accepted: 30 December 2025 | Published: 09 January 2026
Keywords: stroke; brain hemorrhage; cerebral ischemic stroke;age comparison; africa
Background: Whether it is ischemic, hemorrhagic, cerebellar, or transient, age at the time of the event cannot be considered a simple demographic parameter; it constitutes a crucial factor likely to shed light on the nature of the underlying vascular process. While age is recognized as a major risk factor for all types of stroke, its distribution according to subtypes remains insufficiently characterized, particularly in rigorous comparative analyses. It is within this perspective that the present study aims to systematically analyze the variations in age according to stroke subtypes.
Methods: We conducted a cross-sectional analysis of patients diagnosed with ischemic stroke, cerebral hemorrhagic stroke, cerebellar stroke, or transient ischemic attack (TIA). Age differences across groups were assessed using one-way ANOVA, followed by Tukey’s HSD post-hoc tests.
Results: A significant effect of stroke subtype on age was observed (F (3,185) = 3.29, p = 0.0219). Post-hoc analysis revealed that patients with cerebral hemorrhagic stroke were significantly older than those with ischemic stroke (mean difference = 5.7 years, 95% CI [0.47–10.94], p = 0.027). No other comparisons reached statistical significance. Graphical analyses showed that the majority of patients were aged 50–69, with a slightly higher proportion of women in the 60–69 group. Ischemic and haemorrhagic strokes were more frequent in men, though women showed a relatively higher proportion of ischemic events.
Conclusion: Age at stroke onset varies significantly by subtype. Cerebral haemorrhagic stroke is more likely to occur at an older age, supporting its association with vascular fragility and long-standing hypertension. In contrast, ischemic stroke spans a broader age spectrum, underscoring the need for vigilance across all adult age groups. These findings reinforce the clinical value of considering patient age in the early differentiation of stroke subtype, particularly in high-burden settings.
Stroke, while broadly known in its terminology, encompasses a pathological diversity where each subtype presents a specific clinical and pathophysiological profile. Whether it is ischemic, hemorrhagic, cerebellar, or transient, age at the time of the event cannot be considered a simple demographic parameter; it constitutes a crucial factor likely to shed light on the nature of the underlying vascular process.
While age is recognized as a major risk factor for all types of strokes, its distribution according to subtypes remains insufficiently characterized, particularly in rigorous comparative analyses. Global data suggest that age influences the type of stroke: notably, a study by Feigin et al., published in Lancet Neurol (2009), revealed that intracerebral hemorrhage generally occurs at a more advanced age than ischemic stroke, while ischemia can appear at more varied ages [1]. Could this trend observed in Western populations apply to our African context, where the early onset of arterial hypertension is increasingly frequent? Certain African studies provide insights into this question: the multicentric SIREN study conducted in West Africa showed differences in age according to stroke subtype, with a tendency for hemorrhagic forms to occur in older patients than ischemic forms [2]. Furthermore, a Ghanaian study using computed tomography scans confirmed this regional trend, reporting a higher average age in patients with hemorrhagic stroke compared to ischemic stroke [3].
It is within this perspective that the present study, conducted at the Yaoundé Emergency Center (Cameroon), is situated. It aims to systematically analyze the variations in age according to stroke subtypes, in order to refine the understanding of this risk factor and enrich the epidemiological reasoning on stroke in a relatively undocumented African context.
We carried out a retrospective descriptive and analytical study based on patient records over a one-year period. The research took place at the Yaounde Emergency Center, situated in Yaounde, in the Centre Region of Cameroon. This medical facility comprises an Emergency Department, a Primary Care Unit, an Intensive Care Unit and an Inpatient Ward, for a total of 40 beds.
A total of 2,940 patient records, dated from January 1st to December 31st, 2024, were thoroughly reviewed to identify entries indicating possible stroke symptoms, diagnoses, or imaging results. From this pool, 318 records showed signs consistent with stroke-like conditions. These were selected for more detailed evaluation.
The 318 cases were assessed using established criteria to determine eligibility. After this screening, 189 cases met the requirements for inclusion. Acute neurological symptoms such as weakness on one side of the body, facial drooping, speech difficulties, or sensory changes. Notes indicating a clinical diagnosis of stroke, cerebrovascular accident, or related terminology. Availability of adequate information in the file for meaningful analysis. All age groups were considered. Cases of transient ischemic attacks (TIAs) that resolved completely within 24 hours were also included. Records lacking sufficient detail. Cases where neurological symptoms could be attributed to other confirmed conditions such as trauma, post-seizure paralysis, brain tumors, or abscesses.
Following the inclusion and exclusion process, 189 patient records were selected for the final analysis. A standardized Google Form was used to extract relevant data from the selected records. Information gathered included demographics (age and sex), known risk factors (e.g., high blood pressure, diabetes, smoking, atrial fibrillation), time of symptom onset and arrival at the facility, clinical signs and symptoms, available imaging results, documented diagnosis, treatments administered, and patient outcomes. The data were entered and managed in a Google Sheet and analyzed using R Studio version 2025.5.1.513 on Windows 10/11. A one-way analysis of variance (ANOVA) and Post-hoc pairwise comparisons using Tukey’s HSD test for the statistical analysis.
This research adhered to ethical standards outlined in the Declaration of Helsinki. Approval was granted by the ethics committee of the University of Yaounde I. Patient anonymity was ensured by removing all identifying information during data extraction and analysis. The study depends on existing records, which may be incomplete or inaccurate. As the facility operates in a low-resource setting, access to advanced brain imaging was restricted, possibly affecting diagnostic accuracy. Being a retrospective chart review, there is a risk of unintentional exclusion or misclassification of cases. Lack of uniform follow-up data limited insights into long-term outcomes. This study offers important observations about the age on the prevalence of stroke subtypes in a resource-limited environment. The results can help guide future efforts to improve stroke presentation as a whole.
Age differences across stroke types
We investigated whether age varied across stroke diagnosis sub-categories (cerebral ischemic stroke, cerebral hemorrhagic stroke, cerebellar stroke, and transient ischemic attack [TIA]). A one-way analysis of variance (ANOVA) demonstrated a statistically significant effect of age on stroke type F (3, 185) = 3.29, p = 0.0219.
Post-hoc pairwise comparisons using Tukey’s HSD test revealed that patients with cerebral hemorrhagic stroke were significantly older than those with cerebral ischemic stroke (mean difference = 5.7 years, 95% CI [0.47, 10.94], p = 0.027). No other pairwise comparisons between stroke types were statistically significant (all p > 0.05) (Table 1)
| Analysis | Comparison / Source | DF | Sum Sq | Mean Sq | Mean Difference (years) | 95% CI (Lower–Upper) | F-value | p-value |
| ANOVA | Stroke Type | 3 | 1709 | 569.7 | — | — | 3.29 | 0.0219* |
| ANOVA | Residuals | 185 | 32059 | 173.3 | — | — | — | — |
| Tukey HSD | Cerebral Hemorrhagic – Cerebral Ischemic | — | — | — | –5.70 | –10.94 to –0.47 | — | 0.027 |
| Tukey HSD | Cerebellar – Cerebral Ischemic | — | — | — | –6.99 | –24.37 to 10.39 | — | 0.725 |
| Tukey HSD | TIA – Cerebral Ischemic | — | — | — | –7.99 | –20.50 to 4.52 | — | 0.350 |
| Tukey HSD | Cerebellar – Cerebral Hemorrhagic | — | — | — | –1.29 | –18.83 to 16.25 | — | 0.998 |
| Tukey HSD | TIA – Cerebral Hemorrhagic | — | — | — | –2.29 | –15.02 to 10.44 | — | 0.966 |
| Tukey HSD | TIA – Cerebellar | — | — | — | –1.00 | –21.90 to 19.90 | — | 0.999 |
Table 1. Combined ANOVA and Tukey HSD Post-Hoc Summary for Age Differences Across Stroke Types
Graphical representation
Figure 1 displays the age group distribution by sex, showing that most patients fell into the 50–69 age range, with a slightly higher proportion of women in the 60–69 group.
Figure 1: Age group distribution by gender.
Figure 2 demonstrates the distribution of stroke types by sex, where both ischemic and hemorrhagic strokes were more frequent in men, while women exhibited a relatively higher proportion of ischemic strokes.
Figure 2: Stroke type distribution by sex.
Importantly, Figure 3 illustrates the age distribution of stroke patients stratified by sex and stroke subtype. The boxplots highlight that patients with cerebral hemorrhagic stroke presented with a higher median age than those with ischemic stroke, supporting the ANOVA and Tukey post-hoc results. No marked differences were evident for cerebellar stroke or TIA.
Figure 3: Boxplot of age distribution by stroke type and sex
Clinical interpretation
Taken together, these findings indicate that age is associated with stroke subtype. Specifically, cerebral hemorrhagic stroke was more likely to occur at an older age compared with ischemic stroke. This is clinically relevant, as advanced age is a well-recognized risk factor for cerebral hemorrhage, possibly reflecting vascular fragility and cumulative hypertensive damage. In contrast, ischemic stroke appeared across a broader age range, including relatively younger patients.
Implications for clinical practice
The results underscore the importance of age in stroke risk stratification and diagnosis. In elderly patients presenting with acute neurological deficits, clinicians should maintain heightened vigilance for hemorrhagic stroke as a likely etiology. Conversely, ischemic stroke remains a significant concern across all adult age groups, reinforcing the need for early imaging to confirm the subtype and guide management.
Our results confirm that patients with hemorrhagic stroke are, on average, older than those with ischemic stroke, with an age difference of approximately 5.7 years. This finding aligns with existing literature suggesting that increasing age is a key risk factor for intracerebral hemorrhage, possibly due to cumulative vascular damage, long-standing hypertension, and cerebral amyloid angiopathy in the elderly population [6,7]. In contrast, ischemic strokes are distributed across a wider age range and may be more closely linked to modifiable atherosclerotic and cardioembolic risk factors [8].
Several studies conducted in Africa confirm the importance of age and risk factor control in the occurrence of different types of stroke: In Ethiopia, Fekadu et al. reported an average age of admission for stroke of about 61 years, with a slight predominance of hemorrhagic strokes in older patients, although the age difference was not always statistically significant [6]. In sub-Saharan Africa, a systematic review by Owolabi et al. highlights that patients with hemorrhagic stroke tend to be older than those with ischemic stroke, linked to a high prevalence of poorly controlled hypertension [3]. A study in the Democratic Republic of Congo described an average age of about 60 years for stroke patients, without clear differences between types, underscoring the variability among local populations [9,10]. These African data, although varied, generally point towards a more advanced age for hemorrhagic strokes, linked to vascular fragility associated with chronic hypertension.
The UK Biobank study recently showed that biological age estimated from clinical biomarkers and epigenetic profiles, is a key predictor of the risks of both ischemic and hemorrhagic stroke, highlighting the role of vascular aging in differentiating stroke subtypes [11,12]. In China, Guo Y et al. observed that hemorrhagic strokes often occur at an older age than ischemic strokes, a trend confirmed by several Asian cohorts [13,14]. A European meta-analysis by Feigin et al. also showed that the risk of hemorrhagic stroke increases significantly with age, more so than for ischemic stroke [1].
The significant age difference observed in our study underscores the importance of a differentiated approach in prevention, diagnosis, and management depending on the type of stroke, particularly in an African context where the prevalence of hypertension is high and often poorly controlled. This has several implications:
Diagnostic vigilance – In elderly patients presenting with acute neurological deficits, clinicians should maintain heightened suspicion for hemorrhagic stroke until excluded by neuroimaging.
Preventive strategies – Given that hypertension and cerebral small vessel disease are major contributors to hemorrhage in the elderly, aggressive blood pressure management and vascular risk factor control are crucial in this population.
Resource allocation – Older patients with hemorrhagic stroke often require more intensive care and rehabilitation resources, highlighting the importance of anticipating care needs based on age and stroke type.
Our study highlights a significant age difference between stroke subtypes, with patients suffering from cerebral hemorrhagic stroke being, on average, older than those with ischemic stroke. This finding, consistent with data from the international literature but still poorly documented in African contexts, underscores the central role of vascular aging and chronic hypertension in the occurrence of cerebral hemorrhages in elderly subjects. The significance of this age difference, observed in our population, reinforces the value of a differentiated clinical approach based on the stroke subtype and the patient's profile. It also suggests the utility of earlier and more aggressive screening for vascular risk factors from middle age, as well as the systematic use of brain imaging in elderly patients presenting with an acute neurological deficit. Finally, these results open avenues for future research, particularly on the identification of specific biomarkers for cerebral aging and vascular vulnerability, which could improve the prediction, diagnosis, and personalized management of strokes in resource-limited countries.
All authors have no conflict of interest de declare
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My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
