Intractable central neuralgia Central neuralgia (CP) is defined as pain caused by a disease or dysfunction of the central nervous system due to a primary disease within the central nervous system. Central neuralgia is a common chronic and intractable clinical pain, which is difficult for patients to tolerate due to its large pain area, intense pain intensity, long duration, and mostly combined with sensory hypersensitivity and sensory overload. The etiology of CP is mostly due to cerebral and spinal cord vascular injury (infarction, hemorrhage, vascular malformation), multiple sclerosis, trauma to the brain and spinal cord, spinal cord cavity, brain and spinal cord tumor, abscess, myelitis caused by virus or syphilis, epilepsy, Parkinson’s disease, etc. For the treatment of central neuralgia, there is a lack of effective methods, and most of them are treated with narcotic analgesic drugs, acupuncture, physiotherapy, Chinese medicine, radiofrequency, local closure, etc., which may be effective in the short term, but the long-term effect is poor. At present, the treatment of central neuralgia can still be done by stereotactic intracerebral cluster destruction and electrical or magnetic stimulation, including: motor cortex stimulation (MCS), spinal cord stimulation (SCS), high frequency transcutaneous electrical stimulation (TENS), repetitive transcranial magnetic stimulation (rTMS), deep brain stimulation (DBS), intrathecal infusion of drug pumps, and other treatments. Case: Stereotactic intracerebral nucleus pulposus minimally invasive destruction surgery for intractable central neuralgia (more than 95% pain reduction at one year follow-up without any oral pain medication.) Figure 1 Preoperative cervical MRI Figure 2 Preoperative head MRI (postoperative changes in the cervical spine and a softening foci in the cervical medulla between 3 and 4) (multiple lacunar infarcts at the edge of the lateral ventricles) Intraoperative Figure 3 Postoperative MR review of cingulate gyrus destruction Figure 4 Postoperative MR review of bilateral volar nucleus destruction