I suspect that I am not alone in associating the
Cranium Rats with Planescape Torment, that most glorious of games. One of the few monsters in this book that I knew about before I opened it, they seem oddly lacking in flavour here to me. I might have gotten carried away talking about them here, so expect a long post!
A Planescape monster is always a good excuse for DiTerlizzi art. The picture in Volo's really plays up the brain angle, with some impressive digital art used to draw the eye to the glowing organ in question. With a general tone of savagery, I quite like it. Perhaps it might that years of playing Warhammer have trained me to respect pictures of angry evil rats.
These guys are spies and minions for Mind Flayers, who created approximately 15% of all monsters in D&D. Being small they obviously make good spies, but I can't help but feel that the glowing brain is perhaps a giveaway to the careful observer. Otherwise, the rather short flavour text spends most of its time describing how more rats equals more pew pew.
To briefly dip into the past, these guys were most noted in Planescape for a strong association with Ilsensine, the Mind Flayer godthing. It was actually a giant brain living inside a cavernous mountain somewhere in the Outlands, as I recall, and gave blinding headaches and eventual thralldom to anyone who approached it; the Cranium Rats were supposed to be directed by it, doubtless part of a scheme to control the multiverse.
In Planescape Torment, the Cranium Rats had a giant controlling mind, Many-As-One, which the player could go and negotate with, without any mention made of Mind Flayers; at least, that is what Google tells me, for I have not played it in a very long time. (I deliberately left it fallow so that I would forget most of it, and could replay it at a future point from complete ignorance.)
Here, the Cranium Rats are just servants of an individual Elder Brain, as the Mind Flayers appear to have had all hints of universal organisation taken away from them, in favour of them being scattered city-states. Probably that was felt to be more useful for the individual DM. Thus we now have Cranium Rats as minions of a Mind Flayer settlement - good for the introductory stages of an adventure, as the players find the Rats spying on them, and for being monsters encountered on the outskirts of the settlement itself. Not a lot to say about that really, except to mention it as a good idea.
You can also use a Cranium Rat swarm as a low level boss-style threat to the players, but I think that there are better options out there. The exception would be for a whodunnit mystery, where you could use the Cranium Rats as a behind-the-scenes mastermind, taking control of people long enough to sow dissent, and then scuttling away into the shadows to keep their presence hidden. That would be pretty interesting actually, and really play to the strengths of the concept, with or without Mind Flayers being involved.
We here get two statblocks for the Cranium Rats: an individual rat (which is basically a rat that you can't read the mind of) and a swarm. There isn't really a lot to say about a rat by itself, so we'll focus on the Swarm, which has a pretty fruity statblock. At CR 5, but with only 36 HP, these guys will die like champions if the players try hard enough, even if they are resistant to piercing/bludgeoning/slashing. They are also resistant to the Stunned condition, which is really rare as far as I can tell, so they're good for victimising your Monk players. They only get one attack, for reasonable but not amazing damage. So far, so dull.
However, the Cranium Rats can cast
Dominate Monster,
Confusion, and
Command. This means that they can cause a party to descend into total carnage if saves are failed, and could just sit back and mock them telepathically as they hit each other and whatnot. So I think that they'll be quite a swingy monster; if the players get the jump on it, or if they pass their saves, it'll be a total cakewalk; but if they fail their saves, then it could have a surprisingly chaotic outcome. Combine a Swarm with a Mind Flayer, and its blasts, as well as an Intellect Devourer trying to eat brains, and I'm sure that nobody will be happy with you.
Overall, a slight disappointment, but there is hope that they'll turn up in a future
Volo's Guide to the Planes or Mind Flayer-centric adventure path and get a more interesting depiction there.