The causes of headache include physiological factors, tension headache, viral infection, trigeminal neuralgia and so on. 1. Physiological factors: when the patient is overworked and sleep deprived, the symptom of headache like a pinprick may appear. 2. Tension headache: when the patient is overly nervous or psychological pressure is too large, it may trigger tension headache, the patient may show the top of the head like pins and needles like a burst of pain, which may be accompanied by the head of the obvious sense of tightness. 3. Viral infections: When there is a viral infection in the head area, headaches like pins and needles can also occur. 4. Trigeminal neuralgia: the branches of the ophthalmic branch of the trigeminal nerve include the frontal area, the top of the head, and the peri-auricular area, and the attack manifests itself as obvious and severe electric shock-like, pinprick-like, knife-cutting, or tearing pain. The top of the head like pins and needles pain can also be caused by other factors, it is recommended that patients seek medical attention in a timely manner, to clarify the cause, under the guidance of the doctor targeted treatment.