There are more causes of paroxysmal pain in the top of the head, and the common situations are as follows: 1. local factors: local trauma, myotonic headache, local myofasciitis, etc.; 2. medical factors: blood pressure fluctuation, cardiac arrhythmia including bradycardia and tachycardia, as well as fever and infection; 3. other factors: such as nerve compression, cervical spine disc herniation, compression of the nerves in the area innervating the head appear abnormal. To clarify the cause patients need to undergo relevant examinations, such as cranial MRI, cervical MRI, cervical soft tissue ultrasound, carotid artery and vertebral artery ultrasound, etc., to clarify whether it is an intra- or extra-cranial factor. If the attack is occasional or of short duration, the pain symptoms can be relieved by rest, better nutrition and exercise. If the attack is longer, the cause needs to be clarified by imaging auxiliary examination and then targeted treatment.