A new risk factor? Diagonal earlobe crease (Frank's sign) associated with intracranial aneurysms: a case–control study
Objective: To evaluate the association of diagonal earlobe crease (DELC, Frank's sign), laterality, and type of DELC with the presence of intracranial arterial aneurysms (IAA). Methods: The authors conducted a hospital-based case–control study involving 130 patients diagnosed with IAA and 130 a...
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Elsevier
2025-07-01
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| Series: | World Neurosurgery: X |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590139725000432 |
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| author | Victor Ramzes Chavez-Herrera Bayron A. Sandoval-Bonilla Joel Abraham Velazquez-Castillo Pedro Adrian Gonzalez-Zavala Flavio Hernandez-Gonzalez Felix Adrian Vergara-Martinez Anabel Saldaña-Gonzalez Miguel Abdo-Toro Blas Ezequiel Lopez-Felix Ivan Tellez-Medina Martin Paredes-Cruz Rabindranath Garcia-Lopez |
| author_facet | Victor Ramzes Chavez-Herrera Bayron A. Sandoval-Bonilla Joel Abraham Velazquez-Castillo Pedro Adrian Gonzalez-Zavala Flavio Hernandez-Gonzalez Felix Adrian Vergara-Martinez Anabel Saldaña-Gonzalez Miguel Abdo-Toro Blas Ezequiel Lopez-Felix Ivan Tellez-Medina Martin Paredes-Cruz Rabindranath Garcia-Lopez |
| author_sort | Victor Ramzes Chavez-Herrera |
| collection | DOAJ |
| description | Objective: To evaluate the association of diagonal earlobe crease (DELC, Frank's sign), laterality, and type of DELC with the presence of intracranial arterial aneurysms (IAA). Methods: The authors conducted a hospital-based case–control study involving 130 patients diagnosed with IAA and 130 age-grouped and sex-matched controls who had no arterial intracranial aneurysms. This study aimed to evaluate a potential association between IAA and DELC, the laterality of DELC, and the type of DELC. Multivariable logistic regression models were applied to identify correlations between cases and controls. Results: DELC was identified in 96 patients of the IAA group (73.8 %) and 45 in the control group (34.6 %). There was a significant association between IAA and DELC (OR 7.92, 95 % CI 3.96–15.83, p < 0.001), unilateral and bilateral DELC (OR 7.36, 95 % CI 2.96–18.31, p < 0.001, and OR 8.17, 95 % CI 3.90–17.14, p < 0.001, respectively), and type 2, type 3, and type 4 DELC (OR 5.66, 95 % CI 2.17–14.77, p < 0.001, OR 5.73, 95 % CI 1.95–16.83, p 0.001, and OR 39.45, 95 % CI 12.40–125.50, p < 0.001, respectively). Type 1 DELC was not associated with IAA (p 0.079). Conclusions: This study demonstrates a significant association between DELC and the presence of IAA. Laterality was not a limiting factor. Complete and deep features in DELC are associated with IAA, whereas superficial incomplete DELC is not. Hypertension also showed an association with IAA. DELC should be considered a risk factor for IAA. DELC could serve as a crucial candidate risk factor for determining prognosis and screening protocols for patients with IAA; this may enable timely interventions to improve outcomes. |
| format | Article |
| id | doaj-art-9ed5509355a64db49de6857432b59cd8 |
| institution | Kabale University |
| issn | 2590-1397 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Neurosurgery: X |
| spelling | doaj-art-9ed5509355a64db49de6857432b59cd82025-08-20T03:51:29ZengElsevierWorld Neurosurgery: X2590-13972025-07-012710046910.1016/j.wnsx.2025.100469A new risk factor? Diagonal earlobe crease (Frank's sign) associated with intracranial aneurysms: a case–control studyVictor Ramzes Chavez-Herrera0Bayron A. Sandoval-Bonilla1Joel Abraham Velazquez-Castillo2Pedro Adrian Gonzalez-Zavala3Flavio Hernandez-Gonzalez4Felix Adrian Vergara-Martinez5Anabel Saldaña-Gonzalez6Miguel Abdo-Toro7Blas Ezequiel Lopez-Felix8Ivan Tellez-Medina9Martin Paredes-Cruz10Rabindranath Garcia-Lopez11Department of Neurosurgery, Instituto Mexicano del Seguro Social, National Medical Center, XXI Century, Specialties Hospital, Mexico; Universidad Nacional Autónoma de México, México City, Mexico; Corresponding author. Department of Neurosurgery, Instituto Mexicano del Seguro Social, National Medical Center, XXI Century, Specialties Hospital, Mexico City, Mexico.Department of Neurosurgery, Instituto Mexicano del Seguro Social, National Medical Center, XXI Century, Specialties Hospital, Mexico; Universidad Nacional Autónoma de México, México City, Mexico; Department of Neurosurgery, Medica Sur Hospital, Mexico City, MexicoDepartment of Neurosurgery, Instituto Mexicano del Seguro Social, National Medical Center, XXI Century, Specialties Hospital, Mexico; Universidad Nacional Autónoma de México, México City, MexicoDepartment of Neurosurgery, Instituto Mexicano del Seguro Social, National Medical Center, XXI Century, Specialties Hospital, Mexico; Universidad Nacional Autónoma de México, México City, MexicoDepartment of Neurosurgery, Instituto Mexicano del Seguro Social, National Medical Center, XXI Century, Specialties Hospital, Mexico; Universidad Nacional Autónoma de México, México City, MexicoDepartment of Radiology, Instituto Mexicano del Seguro Social, Centro Medico Nacional, Siglo XXI, Hospital de Especialidades, Cuidad de Mexico, MexicoDepartment of Radiology, Instituto Mexicano del Seguro Social, Centro Medico Nacional, Siglo XXI, Hospital de Especialidades, Cuidad de Mexico, MexicoDepartment of Neurosurgery, Instituto Mexicano del Seguro Social, National Medical Center, XXI Century, Specialties Hospital, Mexico; Universidad Nacional Autónoma de México, México City, MexicoDepartment of Neurosurgery, Instituto Mexicano del Seguro Social, National Medical Center, XXI Century, Specialties Hospital, Mexico; Universidad Nacional Autónoma de México, México City, MexicoDepartment of Neurosurgery, Instituto Mexicano del Seguro Social, National Medical Center, XXI Century, Specialties Hospital, MexicoResearch Unit for Epidemiology and Health Services, Instituto Mexicano del Seguro Social, Centro Medico Nacional, Siglo XXI, Cuidad de Mexico, MexicoDepartment of Neurosurgery, Instituto Mexicano del Seguro Social, National Medical Center, XXI Century, Specialties Hospital, Mexico; Universidad Nacional Autónoma de México, México City, Mexico; Department of Neurosurgery, American British Cowdray Medical Center (ABC), Mexico City, MexicoObjective: To evaluate the association of diagonal earlobe crease (DELC, Frank's sign), laterality, and type of DELC with the presence of intracranial arterial aneurysms (IAA). Methods: The authors conducted a hospital-based case–control study involving 130 patients diagnosed with IAA and 130 age-grouped and sex-matched controls who had no arterial intracranial aneurysms. This study aimed to evaluate a potential association between IAA and DELC, the laterality of DELC, and the type of DELC. Multivariable logistic regression models were applied to identify correlations between cases and controls. Results: DELC was identified in 96 patients of the IAA group (73.8 %) and 45 in the control group (34.6 %). There was a significant association between IAA and DELC (OR 7.92, 95 % CI 3.96–15.83, p < 0.001), unilateral and bilateral DELC (OR 7.36, 95 % CI 2.96–18.31, p < 0.001, and OR 8.17, 95 % CI 3.90–17.14, p < 0.001, respectively), and type 2, type 3, and type 4 DELC (OR 5.66, 95 % CI 2.17–14.77, p < 0.001, OR 5.73, 95 % CI 1.95–16.83, p 0.001, and OR 39.45, 95 % CI 12.40–125.50, p < 0.001, respectively). Type 1 DELC was not associated with IAA (p 0.079). Conclusions: This study demonstrates a significant association between DELC and the presence of IAA. Laterality was not a limiting factor. Complete and deep features in DELC are associated with IAA, whereas superficial incomplete DELC is not. Hypertension also showed an association with IAA. DELC should be considered a risk factor for IAA. DELC could serve as a crucial candidate risk factor for determining prognosis and screening protocols for patients with IAA; this may enable timely interventions to improve outcomes.http://www.sciencedirect.com/science/article/pii/S2590139725000432Diagonal earlobe creaseCerebrovascular diseaseFrank's signIntracranial aneurysms |
| spellingShingle | Victor Ramzes Chavez-Herrera Bayron A. Sandoval-Bonilla Joel Abraham Velazquez-Castillo Pedro Adrian Gonzalez-Zavala Flavio Hernandez-Gonzalez Felix Adrian Vergara-Martinez Anabel Saldaña-Gonzalez Miguel Abdo-Toro Blas Ezequiel Lopez-Felix Ivan Tellez-Medina Martin Paredes-Cruz Rabindranath Garcia-Lopez A new risk factor? Diagonal earlobe crease (Frank's sign) associated with intracranial aneurysms: a case–control study World Neurosurgery: X Diagonal earlobe crease Cerebrovascular disease Frank's sign Intracranial aneurysms |
| title | A new risk factor? Diagonal earlobe crease (Frank's sign) associated with intracranial aneurysms: a case–control study |
| title_full | A new risk factor? Diagonal earlobe crease (Frank's sign) associated with intracranial aneurysms: a case–control study |
| title_fullStr | A new risk factor? Diagonal earlobe crease (Frank's sign) associated with intracranial aneurysms: a case–control study |
| title_full_unstemmed | A new risk factor? Diagonal earlobe crease (Frank's sign) associated with intracranial aneurysms: a case–control study |
| title_short | A new risk factor? Diagonal earlobe crease (Frank's sign) associated with intracranial aneurysms: a case–control study |
| title_sort | new risk factor diagonal earlobe crease frank s sign associated with intracranial aneurysms a case control study |
| topic | Diagonal earlobe crease Cerebrovascular disease Frank's sign Intracranial aneurysms |
| url | http://www.sciencedirect.com/science/article/pii/S2590139725000432 |
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