A diagonal earlobe crease heralds intracranial carotid artery atherosclerotic plaques on cone beam images, an acknowledged cause of stroke

OBJECTIVE: An observational study was conducted to determine whether neurologically asymptomatic older male patients demonstrating a diagonal earlobe crease (DELC), a known "risk factor" for future stroke, predicts the presence of petrous/cavernous segment intracranial internal carotid artery calcified atherosclerotic plaques (IICACAPs) on cone beam computed tomography (CBCT) images. STUDY DESIGN: Two maxillofacial radiologists examined facial photographs, determining by consensus the presence of DELC+ among 51 male patients (≥55 years). Masked as to DELC status, the radiologists then determined by consensus the presence of IICACAPs on CBCT images. Finally, they queried each participant as to their atherogenic risk factors. RESULTS: The study group (DELC+) consisted of 31 male patients (mean age 69.54±8.46 years) and the control group (DELC-) included 20 male patients (mean age 66.2±6.78 years). Among the total number (N = 28) of patients evidencing IICCAPs, 19 were DELC+ (67.85%) and 9 (32.14%) were DELC-. . The difference in the prevalence rates of IICACAPs between groups was statistically significant (P = .0125), as was a history of hypertension, which was found mainly in the DELC+ cohort (P = .033). CONCLUSIONS: Older, hypertensive men with DELC are significantly more likely to show IICACAPs on their CBCT images than are those without a crease.