What does a headache on top of the head mean?

Experiencing a headache at the top of the head can stem from various factors. The causes encompass tension, migraines, and occipital neuralgia among others. Certain instances may necessitate seeking medical assistance.

In certain situations, it is advisable to consult a healthcare professional when dealing with a headache, particularly when it is intense, persistent, or accompanied by additional symptoms. In this article, we will delve into various causes of headaches that specifically impact the top of the head, exploring their underlying reasons and providing guidance on when it is crucial to seek medical attention.

1. Tension Headache

Tension-type headaches, also known as muscle contraction tension headaches, are among the most prevalent forms of headaches. While muscular tension may contribute to their occurrence, the precise reasons behind these headaches remain unclear. Other potential factors include vitamin deficiencies and genetic influences. According to a study, it has been suggested that at least 78% of individuals experience a tension-type headache at some point in their lives.

When a tension-type headache occurs, individuals often perceive a sensation of pressure or heaviness in a specific area, such as the top of the head. In certain cases, pain may also be felt in the neck or shoulders.

Describing the pain from tension headaches as dull, individuals typically note that it lacks a throbbing or pulsating quality. Tension headaches are generally uncomfortable but not severe in nature. They can persist from 30 minutes up to a week, although the average duration falls within the range of 4 to 6 hours.

2. Migraine Headache

Migraine, a condition characterized by recurrent headaches, often manifests with headache as one of its prominent symptoms. It affects a considerable portion of the population, with approximately 12% of people being impacted, including 17% of females and 6% of males. Although less common than tension headaches, migraines tend to be more intense in nature.

The pain experienced during a migraine episode can be perceived as originating from the top of the head, radiating along one side, or extending down the back of the neck. It is often severe and pulsating, accompanied by additional symptoms such as nausea and heightened sensitivity to light or sound.

While genetic factors are believed to contribute to the development of migraines, many individuals with the condition also identify specific triggers that can precipitate migraine headaches. These triggers may include stress, changes in weather patterns, sleep disturbances, and hormonal fluctuations.

3. Chronic Headaches

Various forms of chronic or persistent headaches exist, including tension-type headaches and migraine headaches.

For the diagnosis of chronic tension-type headaches, a medical professional typically considers a person to have this condition if they experience tension-type headaches for at least 15 days per month over a period of 3 months or longer. Chronic migraine headaches, on the other hand, occur for at least 15 days per month for 3 months or longer, and the individual will exhibit migraine symptoms on at least 8 days per month.

The specific symptoms experienced will vary depending on the type of headache, but some chronic headaches can result in pain near the top of the head. Lifestyle factors, such as stress and inadequate sleep, can also influence the occurrence and severity of chronic tension headaches.

4. Cluster Headaches

Cluster headaches, as indicated by their name, occur in clusters or groups. They manifest suddenly on one side of the head, typically behind the eye, and are characterized by intense pain accompanied by nasal congestion or a runny nose, as well as a watery eye. These headaches are relatively rare, affecting approximately 1 in 1,000 people.

The underlying causes of cluster headaches may involve alterations in the trigeminal nerve, the hypothalamus, and the dilation of blood vessels. However, the exact reasons for their occurrence remain unknown. Certain triggers, such as watching television, consuming alcohol, exposure to hot weather, and experiencing stress, can potentially precipitate cluster headaches.

Cluster headaches tend to appear in distinct patterns. An episode can persist for several weeks to a few months, followed by a period of remission that can last several years. During an active cluster headache phase, attacks can occur as frequently as every second day, up to eight times a day. This can make it extremely challenging for individuals to find relief or obtain sufficient rest during this period.

5. Sinus Headaches

Sinus inflammation caused by illness or infection can lead to pain in the sides and top of the head. However, addressing the underlying issue typically alleviates these symptoms. Medical professionals may prescribe medications to mitigate inflammation. In cases of chronic sinus problems, surgical intervention might be necessary.

6. Sleep Deprivation Headache

Sleep disturbances can contribute to the onset of headaches, while headaches can also exacerbate sleep problems. In the case of tension-type headaches, a lack of sleep can lead to a decrease in the release of a chemical called orexin, which is involved in regulating the nervous system, sleep, and wakefulness. This decrease in orexin levels may contribute to the occurrence of tension-type headaches.

7. Nighttime Headaches

Hypnic headaches have the peculiar characteristic of waking a person up from sleep, often occurring consistently at the same time each night. These headaches typically endure for at least 15 minutes and are more commonly experienced by individuals over the age of 50. The exact causes of hypnic headaches remain unknown to medical professionals, although potential connections have been suggested with pain management, REM sleep, and melatonin production. Further research is required to gain a better understanding of this type of headache.

8. Occipital Neuralgia

Occipital neuralgia is characterized by the irritation of nerves that extend from the spine to the top of the head. This condition can lead to pain in the back or top of the head.

Individuals with occipital neuralgia often describe a sensation of wearing a tight band around their head. They may also experience tingling or sudden jolts of shocking pain. The scalp may feel tender, and light sensitivity in the eyes can be present.

Potential causes of occipital neuralgia include trauma to the back of the head, nerve compression due to tense neck muscles, nerve compression resulting from osteoarthritis, or the presence of a tumor in the neck.

When diagnosing occipital neuralgia, doctors typically conduct tests to identify any underlying causes, although in some cases, the cause remains unclear.

9. Medication Overuse Headaches

Regular and excessive use of over-the-counter (OTC) or prescription pain medications can lead to the development of overuse headaches or rebound headaches. Individuals with chronic migraines are particularly susceptible to these types of headaches.

In cases where a person has a primary headache condition and experiences headaches for at least 15 days per month, medical professionals will assess the possibility of an overuse headache.

10. Brain Freeze

Exposure to cold temperatures can trigger a specific type of headache known as a cold-stimulus headache or “brain freeze.” This headache typically causes pain at the front of the head towards the top. It is commonly experienced when consuming large bites of something frozen or drinking very cold beverages.

The scientific term for brain freeze is sphenopalatine ganglioneuralgia, which refers to its impact on the sphenopalatine ganglion, a cluster of nerve cells connected to the sinuses.

When a person consumes something cold, they may suddenly experience a sharp and intense pain at the top of their head. However, this pain typically lasts only a few seconds and subsides once the cold temperature in the head dissipates. Interestingly, research has also found a link between sphenopalatine ganglioneuralgia and other types of headaches, including cluster and migraine headaches.

11. Exercise Headaches

Certain individuals may experience a pulsating headache when engaging in sudden and intense physical activities, such as sprinting or engaging in sexual activity. This type of headache is referred to as a primary exercise or exertional headache. The American Migraine Foundation suggests that it may be linked to a rise in blood pressure.

However, there is also evidence to support that exercise can actually help reduce the frequency and intensity of migraine headaches.

To minimise the risk of exercise-induced headaches, it is recommended to consume a source of protein, such as nuts, approximately 1.5 hours before exercising, stay adequately hydrated, and warm up before engaging in strenuous activities.

It is crucial for individuals who experience severe headaches after exercising or have concerns about the impact of exercise on their headaches to seek medical advice for proper evaluation and guidance.

12. Other Causes of Headache

While high blood pressure rarely directly causes headaches, the American Heart Association acknowledges that it may lead to headaches if blood pressure levels reach 180/120 mm/Hg or higher.

In rare instances, certain conditions such as head injuries, strokes, or brain abscesses can result in a condition called intracranial hypertension. This condition involves an increase in pressure around the brain, leading to symptoms such as throbbing headaches, changes in vision, nausea, and other related symptoms.

A severe and sudden “thunderclap” headache could be indicative of a life-threatening condition called reversible cerebral vasoconstriction syndrome (RCVS), which may be caused by bleeding in the brain or a stroke. Immediate medical attention is necessary for this type of headache.

Do the Muscles in the Head Play a Role?

While the top of the head has fewer muscles compared to other areas, they can still contribute to certain types of headaches. Tension-type headaches, for example, may involve the tightening of neck and head muscles. Excessive muscle contractions around the head can potentially reduce blood supply and trigger the release of substance P, a neurotransmitter associated with pain amplification, which can further exacerbate the pain experienced in headaches.

Treatment of Headache on the Top of Head

The treatment options for a headache in the top of the head vary depending on the underlying cause. Here are some common approaches:

1. Over-the-counter pain relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) can be effective in alleviating headache pain.

2. Dietary measures: Increasing water intake and reducing alcohol consumption may help manage headaches.

3. Massage: Self-massaging the head and neck or seeking professional massage therapy can provide relief.

4. Relaxation techniques: Practicing relaxation techniques such as deep breathing exercises or yoga can help reduce headache symptoms.

5. Stress reduction: Managing stress levels through various techniques, including meditation and mindfulness, may help prevent or lessen headaches.

6. Adequate sleep: Ensuring a proper sleep routine and obtaining sufficient rest can contribute to headache prevention.

7. Physical or massage therapy: Working with a physical therapist or seeking specialized massage therapy can target muscle tension and provide relief.

8. Acupuncture: Acupuncture, an alternative therapy involving the insertion of thin needles, may be beneficial in some cases.

9. Biofeedback: Biofeedback techniques, which involve learning to control bodily functions, can help manage headaches.

10. Cool packs: Applying cool packs or cold compresses to the head can help alleviate pain and reduce inflammation.

If a doctor identifies a specific cause for the headache, they may recommend targeted treatments to address the underlying issue.

When to see a doctor

It is important for individuals to seek medical assistance if they experience the following:

1. Severe, sudden headache: A sudden and intense headache, often referred to as a “thunderclap” headache, could be a sign of a serious underlying condition and requires immediate medical attention.

2. Persistent headaches: If headaches persist and do not improve with self-care measures or over-the-counter pain relief, it is advisable to consult a doctor for further evaluation and management.

3. Associated symptoms: If headaches are accompanied by additional symptoms such as nausea, vomiting, changes in vision, or neurological abnormalities, it is essential to seek medical help to determine the underlying cause.

A healthcare professional may prescribe medications to alleviate symptoms or perform diagnostic tests to identify any underlying causes that require specific treatment. It is always important to consult a medical professional for an accurate diagnosis and appropriate management of persistent or severe headaches.


Headaches that occur in the top part of the head can stem from various causes. While tension-type headaches are frequently encountered and can often be managed with self-care measures, it is important to be aware of certain scenarios that warrant medical attention.

If a headache is sudden, severe, or persistent, it may indicate an underlying condition that requires medical evaluation and treatment.

It is advisable for individuals experiencing troublesome or persistent symptoms to seek medical help. In the case of a sudden, severe “thunderclap” headache, it is crucial to take immediate action by calling 911 or taking the affected person to the nearest emergency room.

Prompt medical attention ensures proper diagnosis, appropriate management, and timely intervention for any underlying conditions associated with the headache.

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