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Cerebral herniation in patients receiving cisplatin
R W Walker1, J G Cairncross, J B Posner
1Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York.
Journal of Neuro-Oncology
|January 1, 1988
Summary
Intravenous cisplatin therapy can cause brain swelling, herniation, and coma in patients with brain lesions. This rare side effect may be linked to fluid shifts and cisplatin's potential neurotoxicity.
Area of Science:
- Neuro-oncology
- Nephrology
- Clinical Neurology
Background:
- Cisplatin is a widely used chemotherapy agent for various cancers.
- Intracranial mass lesions present unique challenges in managing treatment side effects.
- Cerebral herniation and coma are severe neurological complications.
Observation:
- Five patients with intracranial mass lesions developed cerebral herniation and coma after intravenous cisplatin.
- The onset of neurological symptoms occurred following cisplatin administration.
Findings:
- The exact cause of acute cerebral swelling is undetermined.
- Potential factors include pre-existing cerebral edema, hypo-osmolality leading to fluid shifts, seizures, and direct cisplatin neurotoxicity.
Implications:
- This highlights a potential severe neurological adverse event associated with cisplatin chemotherapy.
- Clinicians should be vigilant for these symptoms in patients with brain lesions receiving cisplatin.
- Further research is needed to elucidate the precise pathogenesis and develop preventative strategies.