Résumé
The traditional way to select tasks for intraoperative mapping is based upon the lobar location of the lesion, in a localizationist view of brain processing. However, neurosurgeons must remind that the experience is mainly built on the power of clinical observation, which regularly raises into question the “a priori knowledge” learnt at university. To see the real truth face of each patient, the first step is to collect information without bias or blinders, even if not in agreement with preconceptions about functional anatomy. Second, based on such discrepancies between theory and practice (e.g., recovery after resection of “eloquent” sites), our own brain will propose alternative hypotheses guided by feelings: such a non-conscious process can be called intuition. Third, new concepts challenging dogmas, as the original meta-networking model of neural functions, should be validated, thanks to the feedback from the patient before, during, and after surgery. In this dynamic organization of cerebral circuitry, functional connectivity and neuroplasticity must be taken into account for intrasurgical task selection and postoperative cognitive rehabilitation. Next, with these new principles in mind, medical doctors and researchers may tend toward a higher level of automation, freeing up time and energy to continue to observe the brain and to elaborate, again, updated models closer to reality. The ultimate aim of this unending virtuous spiral is to permit patients not only to live longer but also to be human beings able to dream and to create. Free will is the common thread to sublimate unique relationship between physician and patient.