AJM onlineClinical research studyDiagonal Earlobe Crease (Frank's Sign): A Predictor of Cerebral Vascular Events
Section snippets
Methods
This was a prospective study that enrolled consecutive patients (men and women) over the age of 18 years who were admitted with an acute ischemic stroke and signed a consent form to participate in the study. The diagnosis was confirmed by a senior neurologist within the first 24 hours. Medical history and physical examination were done for all patients, and data were collected also from their medical history electronic files. Frank's sign was tested in both ears. Clinical data included age,
Results
A total of 241 consecutive patients who were hospitalized with an acute stroke and were eligible to take part in the study were recruited. All had to sign a consent form before enrolment. Frank's sign was present in 190 patients (78.8%) (Table 1). Patients were divided according to clinical findings and the findings on brain computed tomography. There were 153 patients with transient ischemic attack (63.6% of the patients) and 88 with cerebrovascular accident (36.4% of the patients) (Table 2).
A
Discussion
We found that Frank's sign could predict ischemic cerebrovascular events. Patients with classic risk factors for cardiovascular events had Frank's sign at a higher frequency. We found that Frank's sign was more prevalent in patients with cerebrovascular accidents compared with patients with transient ischemic attacks. An increased rate of Frank's sign was found in patients admitted with an acute ischemic stroke and who suffered from myocardial infarction in the past. On the other hand, Frank's
Conclusion
Frank's sign is a sign found in the physical examination that predicts ischemic stroke independently and is found in patients with high risk of developing ischemic stroke even in the absence of ischemic heart disease. It is more common in older age, higher in the presence of cardiovascular risk factors such as hypertension and diabetes, and more frequent in the presence of a previous myocardial infarction or ischemic heart disease. Adding Frank's sign to the list of classic risk factors for the
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Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to data and had a role in writing the manuscript.