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There are many reasons why a headache can occur in the top part of the head. Tension is a common cause, but there are other causes, some of which may need medical attention.

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In some cases, a person may need to consult a doctor about a headache, especially if it is severe, persistent, or occurs with other symptoms.

Here, learn about some causes of headaches that can affect the top of the head, why they happen, and when to seek medical help.

Tension-type headaches are some of the most common headaches. Experts sometimes call them muscle contraction tension headaches. While muscular tension may play a role, it is not clear exactly why they happen. Other possible causes include vitamin deficiencies and genetic factors. One study has suggested that at least 78% of people experience a tension-type headache at some time.

In a tension-type headache, the pain feels as if it is squeezing or adding weight to an area, such as the top of the head. People will also feel pain in their neck or shoulders in some cases.

People often describe the pain from tension headaches as dull and say it does not throb or pulsate. Tension headaches are usually uncomfortable but not severe. They can last from 30 minutes to a week, but the average duration is 4–6 hours.

Learn more about tension headaches.

Headache is one of the symptoms of migraine. Migraine headaches affect up to 12% of the population, including 17% of females and 6% of males. They are less common than tension headaches but can be more severe.

The pain may feel as if it radiates from the top of the head, along one side, or down the back of the neck. It can be severe and throbbing and occur along with other symptoms, including nausea and extreme sensitivity to light or sound.

Genetic factors appear to play a role, but many people with the condition find that specific triggers can cause migraine headaches. These include stress, weather changes, sleep problems, and hormonal changes.

Get some tips here on migraine relief.

There are different types of chronic, or persistent, headache. They include tension-type headaches and migraine headaches.

A doctor will diagnose a chronic tension-type headache if a person has a tension-type headache on at least 15 days a month for 3 months or longer. Chronic migraine headaches also occur on at least 15 days a month for 3 months or longer, and the person will have migraine symptoms on at least 8 days a month.

The symptoms will depend on the type of headache, but some can cause pain near the top of the head. Lifestyle factors, such as stress and lack of sleep, can influence chronic tension headaches.

What can you do if you have a persistent headache?

As the name suggests, cluster headaches occur in groups. They appear suddenly on one side of the head, often behind the eye, and they cause severe pain as well as nasal congestion or a runny nose, and a watery eye. They are rare, affecting around 1 in 1,000 people.

Cluster headaches may involve changes in the trigeminal nerve, the hypothalamus, and blood vessel dilation. However, experts do not know exactly why they happen. They can occur in response to triggers such as watching television, drinking alcohol, hot weather, and stress.

Cluster headaches tend to occur in groups. An attack can last from several weeks to a few months, but may then stop for several years. During an attack, they can occur from every second day up to eight times a day. A person may find it hard to get rest or relief during this time.

Learn more about cluster headaches.

Sickness or infection can inflame the sinuses, resulting in pain in the sides and top of the head. The symptoms usually disappear when a person treats the underlying issue. A doctor may recommend medications to help with inflammation. People with long-term sinus problems may need surgery.

Learn more here about sinus headaches.

Sleep disruption can lead to headaches, but headaches can also worsen sleep problems. Tension-type headaches may occur when a lack of sleep causes the body to release less of a chemical known as orexin. Orexin plays a role in nervous system function, sleep, and arousal.

A lack of sleep is one cause of an early morning headache. What other causes are there?

Hypnic headaches can cause a person to wake up from sleep, usually at the same time each night. They usually last at least 15 minutes and tend to affect people aged over 50 years. Doctors do not know why they happen, but there may be links with pain management, REM sleep, or melatonin production.

Find out more about hypnic, tension, and other types of headaches that can occur at night.

Occipital neuralgia involves irritation to the nerves leading from the spine to the top of the head. This can cause pain in the back or top of the head.

A person may feel as if they have a tight band on their head. They may also experience tingling or jolts of shocking pain. The scalp may feel tender and a person’s eyes can be sensitive to light.

Possible causes include:

  • trauma to the back of the head
  • pinching of the nerves due to tight neck muscles
  • nerve compression resulting from osteoarthritis
  • a tumor in the neck

A doctor will carry out tests to look for an underlying cause, although sometimes there is no clear cause.

Learn more about occipital neuralgia.

Frequent use of over-the-counter (OTC) or prescription pain relief can result in overuse or rebound headaches. People with persistent migraine are especially prone to overuse headaches.

A doctor will consider the possibility of an overuse headache if the person has a diagnosis of a primary headache condition and experiences headaches on at least 15 days a month.

Exposure to cold temperatures may cause a cold-stimulus headache, or “brain freeze,” with pain at the front of the head toward the top. It can happen when eating a large bite of something frozen or consuming very cold drinks.

The scientific term for brain freeze is sphenopalatine ganglioneuralgia, as it affects the sphenopalatine ganglion. This ganglion is linked to nerves in the sinuses.

When a person eats something cold, a sharp, severe pain hits the top of their head and lasts only a few seconds. It disappears once the cold temperature in the head has dissipated. However, experts have also linked the sphenopalatine ganglioneuralgia to other types of headaches, including cluster and migraine headaches.

What exactly is “brain freeze”? Find out here.

Some people develop a throbbing headache when they do sudden, intense exercise, such as running sprints or having sex. Doctors call this a primary exercise or exertional headache. It may be due to a rise in blood pressure, according to the American Migraine Foundation.

However, there is also evidence that exercise can help reduce migraine headaches.

Eating some protein source, such as nuts, around 1.5 hours before exercising, staying hydrated, and warming up may all help reduce the risk.

Anyone who experiences a severe headache after exercising or has concerns about the impact of exercise on headaches should seek medical advice.

Learn more about headaches after exercise.

High blood pressure rarely causes a headache, but the American Heart Association notes that it may do so if blood pressure is 180/120 mm/Hg or above.

In rare cases, a head injury, stroke, or brain abscess can cause a condition known as intracranial hypertension, where pressure builds up around the brain. This can cause a throbbing headache, vision changes, nausea, and other symptoms.

A severe, sudden, “thunderclap” headache may be a sign of reversible cerebral vasoconstriction syndrome (RCVS) due to a life-threatening condition such as bleeding in the brain or a stroke. This type of headache needs immediate medical attention.

There are not many muscles on the top of the head, but they may play a role in some types of headaches. A tightening of the neck and head muscles may play a role in tension-type headaches. Around the head, excessive muscle contraction may reduce blood supply and lead to the release of substance P, which can worsen pain.

There are several ways of treating a headache in the top of the head, depending on the cause.

They include:

  • OTC pain relief, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
  • dietary measures, such as consuming more water and reducing alcohol intake
  • massage, including self-massaging the head and neck
  • relaxation techniques
  • reducing stress levels with breathing exercises or yoga
  • getting the right amount of sleep
  • seeing a physical or massage therapist
  • acupuncture
  • biofeedback
  • cool packs for the head

If a doctor identifies a specific reason for a headache, they may offer treatment to address the cause.

Shop here for a range of over-the-counter treatments for headache pain.

A person should seek medical help if they have:

  • a severe, sudden headache
  • persistent headaches that do not respond to home treatment
  • other symptoms, such as nausea and vision changes

A doctor may prescribe medications or carry out tests to see if there is an underlying cause that needs specific treatment.

There are many reasons why a headache may affect the top part of the head. Tension-type headaches are the most common cause and often respond to home treatment. However, a sudden, severe, or persistent headache may be due to an underlying cause that needs medical treatment.

Anyone experiencing troublesome or persistent symptoms should seek medical help. If a person has a sudden, severe, thunderclap headache, someone should call 911 or take the person to the nearest emergency room.