Ultrasonographic screening in infants with isolated spinal strawberry nevi

Object. The authors performed spinal ultrasonography and/or magnetic resonance (MR) imaging in 20 consecutive newborns with spinal strawberry nevi. Methods. In 15 patients the strawberry nevi were isolated and in five they were associated with other cutaneous markers of occult spinal dysraphism (OSD). In four of five patients with additional cutaneous markers, but in none of those without, MR imaging and surgical exploration demonstrated OSD. The authors found that strawberry nevi in isolation do not appear to indicate underlying dysraphic states. The sparse clinical literature on this topic, which is reviewed, confirms an association between OSD and strawberry nevi presenting in conjunction with other cutaneous signatures. By contrast, spinal strawberry nevi occurring alone may not indicate the presence of underlying dysraphism. Conclusions. A prospective study of larger numbers of patients with isolated strawberry nevi, undergoing MR imaging evaluation, is necessary to determine whether neuroimaging screening in these patients is indicated.