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Health 01/03/2025 02:22

What Causes a Headache on Top of Your Head?

Most headaches, including those at the top of the head (behind the forehead or beneath the scalp near the crown), resolve on their own. Still, some headaches are symptoms of underlying health problems, so it’s important to know the signs that you should seek further care.

Location is just one piece of information, and it may not be the most useful factor when it comes to making a diagnosis, says Elizabeth Loder, MD, vice chair of academic affairs in the department of neurology at Brigham and Women’s Hospital and a professor at Harvard Medical School in Boston. “We ask other questions to narrow the possibilities, including history of injury, migraine, tension-type headaches, or — rarely — a problem like a brain tumor or other abnormality.”

Common Causes of a Headache on Top of the Head

Some of the more common causes of head pain include migraine and tension headaches, Dr. Loder says. These are known as “primary” headaches, meaning they aren’t connected to other health issues. Secondary headaches, on the other hand, stem from other underlying problems, such as sinusitis.

Migraine

Many people have headaches caused by migraine on one side of the head. However, migraine can affect both sides of the head or the top, says Patricia Olson, MD, a neurologist and assistant professor at the Indiana University School of Medicine in Indianapolis. The cause of migraine is unknown, but it’s thought that people with the condition may have inherited or developed (perhaps due to a head injury) a nervous system that’s easily triggered, Loder explains.

“Some migraine triggers might be stress, caffeine withdrawal, dehydration, hormonal changes, sleep changes, and alcohol. All of those could contribute to a migraine attack,” Dr. Olson says.

Headaches caused by migraine usually cause moderate to severe pain, which may be made worse by physical activity and can last hours or days, Loder says. Other migraine symptoms include sensitivity to light or sound, as well as nausea or vomiting.

Tension-Type Headaches

Tension-type headaches are the most common headache type, says Sweta Sengupta, MD, assistant professor in the department of neurology at Duke University School of Medicine in Durham, North Carolina.

“Tension-type headaches are more mild to moderate in intensity. They’re typically described as ‘band-like’ and ‘tight,’” Dr. Sengupta explains.

Also known as stress headaches, these usually stem from muscle tension, eyestrain, sleep disorders, mood disorders, or neck and jaw problems.

Sinus Pressure

“Sinus pressure can be caused by environmental allergens, viruses, or bacteria that result in fluid in the sinuses that does not drain well,” says Rena Sukhdeo Singh, MD, neurologist and medical director of the Primary Stroke Center at the University of Maryland Shore Regional Health in Easton. “The accumulation of the fluid in the sinuses can lead to pressure in the head.”

Other symptoms of sinusitis include pressure-like pain behind the eyes, toothaches, face tenderness, coughing, and nasal stuffiness.

 

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