Résumé
As access to brain MRI is getting wider, it is not uncommon to diagnose incidentally a diffuse low-grade glioma (DLGG) in a neurologically fully asymptomatic patient. Based on the results of maximal safe surgical resection in symptomatic patients—allowing to significantly increase overall survival while preserving quality of life by sparing the cerebral connectome—surgery under local anesthesia with intensive cognitive monitoring and mapping has recently been proposed in incidental DLGG patients. First results showed that, by performing earlier surgery, that is, for smaller tumors, extent of resection was maximized and risk of malignant transformation was minimized, while patients continued to have a normal familial, social and professional life—especially with no epilepsy. As a consequence, it was proposed to set up a policy of screening in the population between 20 and 40 years-old, by offering to healthy volunteers a cerebral MRI. We analyzed the conceptual and practical elements of feasibility, and conclude that benefits would overweight the costs and risks of such a strategy.