Neurotoxicity
Cisplatin
Cisplatin is a bifunctional alkylating agent commonly utilized in many solid tumors, including breast, ovaries, head, neck and lung cancers. Neurotoxicity with cytarabine presents days following any course of therapy. The neurotoxicity presents as “stroke-like” and results from vascular occlusion with ischemic infarctions. Multiple possible causes for vascular toxicity with cisplatin have been proposed, including micro embolism, thrombosis and vasculitis.
Transient hypercoagulability and increased blood viscosity may also contribute to thrombosis in these patients. Additionally, patients receiving cisplatin are commonly hypomagnesemic due to renal tubular injury from the cisplatin. This may contribute to cerebral vasospasm and exacerbate symptoms. Other causes for stroke should be sought in these patients, as this is a rare occurrence. Treatment includes discontinuation of the drug and, if possible, administration of standard therapy such as anticoagulation.
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