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Updated: Jun 27, 2026

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Published on: September 25, 2009
Diagonal Earlobe Crease (Frank's Sign): a New Clinical Sign to Look for in Patients With Ruptured and Unruptured
Victor Ramzes Chavez-Herrera1, Joel Abraham Velazquez-Castillo1, Flavio Hernandez-Gonzalez1
1Department of Neurosurgery, Hospital de Especialidades, Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Ciudad de México, México.
Background And Importance:
Diagonal earlobe crease (DELC, Frank's sign) and intracranial arterial aneurysms (IAA) have a pronounced association with atherosclerosis. Therefore, detecting DELC in patients with IAA could be potential for clinical and research use.
Clinical Presentation:
During a 2-month period, we diagnosed 20 patients with intracranial arterial aneurysms. Sixteen (80%) were positive for DELC, 12 were female, and 4 were male (ages ranging from 32 to 68 years and a mean of 52 years). Eleven were unruptured and 5 were ruptured. We highlight cases 1, 7, and 8.
Conclusion:
The interesting tight association of DELC and IAAs to atherosclerosis and the overwhelming presence of DELC in patients with IAAs could lead to potentially associated DELC with the development, growth, and rupture of IAAs. As a result, important clinical and research information could be found.
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