Cerebral herniation in patients receiving cisplatin.

5 Patients with intracranial mass lesions are described who experienced cerebral herniation and coma following intravenous cisplatin therapy. Although the pathogenesis of the acute cerebral swelling is unknown, it is most likely multifactorial. Possible contributing factors include pre-existing cerebral edema, acute hypo-osmolality with fluid shifts into an already swollen brain, seizures and possible direct neurotoxicity of cisplatin.