Abstract
Background and aims
The diagonal earlobe crease, known as Frank’s sign, has been proposed as a marker of atherosclerotic disease. Its detection could represent a simple tool to identify individuals with high vascular risk. This study aimed to evaluate the prevalence of Frank’s sign in patients with acute cerebrovascular events and its relationship with vascular risk factors and stroke subtypes.
Methods
We conducted an observational, comparative, cross-sectional study with prospective data collection, including 194 patients with acute stroke, of whom 176 presented Frank’s sign.The presence and characteristics of the crease were assessed, along with sociodemographic variables, cardiovascular risk factors, stroke subtypes according to TOAST, ABCD2 score in transient ischemic attacks (TIA), carotid imaging findings and previous treatments. Descriptive analyses and bivariate comparisons were performed to identify associations between the sign and specific clinical profiles.
Results
Most patients were aged 71–90 years, with a balanced sex distribution.Among patients with Frank’s sign, the crease was predominantly bilateral (81.7%), extensive (64.2%), and moderate or deep (71.4%), with 40.3% presenting a double crease.The most frequent risk factors were hypertension (62.4%), dyslipidemia (56.7%), and diabetes mellitus (28.4%), with higher proportions of tobacco and alcohol consumption compared to patients without the sign.In TOAST subtypes, lacunar stroke predominated in patients with the sign, while cryptogenic stroke was more common in those without.Prior use of antiplatelets or anticoagulants did not differ significantly between groups.
Conclusions
Frank' sign detection could serve as a marker for primary prevention, allowing early identification of high-risk individuals and the implementation of preventive interventions before a cerebrovascular event occurs.
Conflict of interest
Lorena Caballero Sánchez; Claudia Gómez López de San Román; Mariano Capra, Inés Bermejo Casado, Débora Cerdán Santacruz; Ana Castrillo Sanz, Julián Berrio Suaza; Gaspar Suárez Fernández; Amelia Mendoza Rodríguez: nothing to disclose