Pressure HeadacheBy pressure headache I mean a headache which feels like there is too much pressure inside your head. It is a tightness in the head, or a squeezing feeling around or on the side of the head.Some of the severe, serious headache types will be experienced as a pressure symptom in the head (more on these below). However, the quality of the pain is not quite as important as the onset and progression. Pressure pains that occur day after day without changing much in intensity and without limiting daily activity are not associated with serious disease. A pressure headache that is worst on wakening and causes severe vomiting on wakening might be serious. A new onset pressure-type headache which gets worse and worse over a few days or weeks may also be due to one of the more dangerous headache conditions. However, before you think a pressure headache is the end of the world, remember that by far the most common cause of a pressure feeling in the head is Tension-type Headache (TTH). The most common headache syndrome known is TTH, and about 40-60% of people will experience a TTH each year! 
Tension-type Headache can cause a pressure, tight, squeezing or band-like sensation all over the head, on part of the head, or around the head. Tension-type headache can be intermittent (episodic tension-type headache) of experienced day-in-day-out (chronic tension-type headache). Tension-type Headache is not usually physically disabling, but unfortunately medication is not usually effective in chronic cases. In episodic cases it is hard to know if medicines work or whether the headache was going to go away itself anyway. Most people who take a tension-type headache, reach for paracetamol (acetaminophen in the USA) and never bother their doctor about the headache have episodic tension-type headache.
Migraine Can Cause Pressure in HeadWhile tension headaches are the most common cause of pressure in the head, people with migraine will also get pressure symptoms.In one survey pressure type pain was reported in 42%, and a more recent survey found pressure symptoms in about 70%. In migraine the location of pressure will move around, and there will also be times when the pain is more intense and starts to fell like a throbbing pain. People with migraine will also experience "sensory sensitivity". In sensory sensitivity there is nausea, intolerance of movement, light or smell. Episodes of pressure type headache may get better if treated like migraine, rather than as tension headache.
What are the Serious Causes of a Pressure Sensation in the Head?For the very, very small number of people (I estimate <0.1%) with a serious cause of pressure headaches, here is the list of potential causes:
ReferencesA Verdelho. Headache in acute stroke. A prospective study in the first 8 days Cephalalgia 2008;28:346-354 (Free Abstract only)DD Mitsikosta. Refractory chronic headache associated with obstructive sleep apnoea syndrome Cephalalgia 2008;28:139-43 (Free Abstract only) JN Blau. Sleep deprivation headache Cephalalgia 1990;10:157-60 (Free Abstract only) CJ Schankin. Characteristics of brain tumour-associated headache Cephalalgia 2007;27:904-11. (Free Abstract only)
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