Sudden headache like needle prick may be caused by hypertension, cerebral hemorrhage, trigeminal neuralgia, migraine, temporal arteritis and other diseases. 1. Hypertension: Emotional excitement, strenuous exercise and other factors induce sympathetic nerve excitation, accelerated heart rate, cerebral vasoconstriction and other factors lead to a transient increase in blood pressure, which can lead to symptoms of pinprick headache. 2. Cerebral hemorrhage: cerebral blood vessel rupture and hemorrhage lead to intracranial pressure increase, brain parenchyma compression, etc., so the symptoms appear. 3. Trigeminal neuralgia: the cause of primary trigeminal neuralgia is unknown, secondary trigeminal neuralgia may be caused by trauma, infection and other factors, which is manifested as recurring electric shock-like, knife-like pain. 4. Migraine: it may be related to heredity, endocrine disorders and mental factors, and is a common primary headache, characterized by episodic, mostly lateralized, moderate to severe, throbbing headache. 5. Temporal arteritis: Due to the inflammatory lesion of temporal artery, there are a lot of inflammatory cells infiltration in all layers of temporal artery, and the main clinical manifestations are headache, redness and swelling of temporal artery. Sudden headache like pins and needles may be related to a variety of factors, it is recommended to consult a doctor for a clear diagnosis.