What could be causing my constant feeling of head pressure?

@xavier99 please describe what you mean by “pressure”. Is the sensation as if someone is squeezing your head? Or is it from the inside?

Did your doctor offer you any suggestions?

Have you had a brain CT w/contrast? I just had surgery for normal pressure hydrocephalus, and I had that sensation of 'pressure' for years along with the other symptoms you describe. Do you have any vision changes?

xavier99:
Have you been tested for lyme disease?
Did you fall & sustained a concussion? How long ago does not matter.
The fact it improves when laying down...you can have a CSF "leak" (very small) in your brain.
If this is so, laying down always makes one feel better. It can be missed on MRIs/CT Scans.
You would need a spinal tap to check for a "leak".
Are you suffering from anxiety? Anxiety and stress are the culprits in so many health issues and it can present itself in so many ways - often weird ways...one would never think it was anxiety.
Can you identify a "trigger" that started this?
Could it be migraines?
I am guessing you are seeing a neurologist. How about a headache specialist?
A neurologist is not always a headache specialist.
Do you have access to a top notch facilityies for neurology?
If not, look at the rankings on World News & World Report for the best facilities. Google it.
Do you have small vessel disease in your brain? The MRI should have showed this... or areas of "hyperintensities"? that means areas of no blood flow...which can cause everything you mentioned.
Again, the MRI should have showed this...did you have IV contrast?
An examination with an opthalmologist?
Rheumatologist for fibromyalgia?
In short, there are a multitude of medical and psychological conditions that can be responsible for your ongoing head pressure.
As difficult as it may be, you must start "ruling" health issues out to try to find the cause.
Wishing you the very best on this journey. It's not easy for sure.

If you're taking good care of yourself with healthful foods (e.g. at least five servings of vegetables and fruits and no highly processed foods, with enough water spread over the day) and a reasonably active lifestyle that provides both aerobic and muscle strengthening needs that add up to At Least 150 minutes each week, as well as have a general sense of control over what your life-purpose is, all showing up in a reasonably strong and fit body and mind...But Yet have somehow developed this enigmatic condition, then I am afraid I don't know what else to do except what you are seeking already.

I say all this because my 'head fog' often disappears when I have Not walked enough to meet my age-adjusted demand (an octogenarian) . Just today, after not having walked for three consecutive days not more than 15 minutes, I took a 45 minute brisk walk. I Still feel fresh six hours later and more clear headed than in the last few days. Too often the Basics of Healthcare need attention. I wish you good health.

Xavier 99 I know what head pressure is. I had head pressure and blurry vision in February. They did a scan and could not find a cause. I spent two nights in the hospital and was discharged without any advice. I have head pressure in the back of my head since February. I also had it in my neck twice with the head pressure. If you put the palm of your hand just above your neck that is where I feel head pressure. I went to several doctors at home and I got nothing. So I researched Houston Texas and they have a bunch of neurologists. They even have neuro-ophthalmologists. I drove from Florida to Houston yesterday. I have family here. I made an appt to a neurologist who I will see on Wednesday the 20th. I am also looking at a neuro-opthalmologist because I did research. On a website for a group of neuro-opthalmologist one of the things that is mentioned is head pressure. I have had my vision checked twice. The first time was after the head pressure and blurry vision. The second time I had feelings come near my eyes then surrounded my eyes. The first time it was stated my retinas were not harmed. The second time they gave me over the counter eye drops for dry eyes. Since I am continuing to have head pressure that is why I want to see a neuro-ophthalmologist. I am going into this for sixth months so I am my own best advocate since no one could help me where I lived. I wanted to see a vascular neurologist. I called them up and they actually had openings. But I had to get a referral and I sent doctors notes. I asked them how long it would take to get a visit. The person said, “They look at your records and decide who is the best person to see.” Come this Tuesday it will be one month and I haven’t heard anything. So I called Houston and have an appt this week. I got an appt. To a neuro-ophthalmologist regarding my eyes and the head pressure. The only thing is that it’s on Sept 29th. I really don’t think I should wait that long. So I am calling more places today since I am here in Houston. I really don’t want to be gone that long but……. One of the things I noticed when I checked a neuro-ophthalmologist website was a list of things and head pressure was one. I also get intermittent head pains. I am going to ask the Dr. that I see on Wednesday about my spinal fluid. Sometimes a persons body will make too much spinal fluid. When I say head pressure the doctor writes headache. I HAVE NOT had a headache in years. I just saw my cardiologist and I do have Hypertension which I take meds for. Two doctors said they think it’s my blood pressure causing this. Well guess what? I take my BP and write it down. When I had head pressure I will write it next to the BP. I showed my cardiologist when my BP was 120/78 I had head pressure. I have had good blood pressures and I have had BP that are just a few points higher than what my Dr told me she was good with. She gave me a range. I will come back when I finish seeing the neurologist and let you know the outcome. I will also let you know the outcome if I see a neuro ophthalmologist. I am a determined woman and I will get answers. Good luck to you and I truly hope you find answers. @rnlorena

Thanks for your advice. Everything you said that may cause this has been ruled out, except for the CSF leak. The strange thing is that what I hear is that low CSF causes headache or head pressure in the back of the head, but in my case I have pressure on the temples and front of the head, so it may not even be a leak. Anyway, I will be seeking this possibility.

Good luck to you too, and please let me know the outcome!

@xavier99
I am thinking it might be Occipital Neuralgia.

Glad to hear so much has been ruled out. rnlorena posted an interesting plan she will be seeking. Yes, sometimes one must travel far to find medical answers no one seems to know in your location.
Remember, there are many, many neurological disorders...some most people have never even heard of. You might fall into this category. The CSF leak usually presents as no "headache/pressure" when lying down. Upon rising, the pain does not start immediately, but will come. I also had pressure on my temple and front of my head and my neurologist thought of a CSF leak which I did not have. Also, remember there are many "types" of migraines. If I were you, I would look at US News & World Report for 2025 medical center rankings. Look at who is #1 in the country for neurology. That's exactly where I would go for another opinion.
Regardless of the distance...the very best of luck to you.

xavier99 I got very lucky today. I have a morning appt on 8/20 for a neurologist that deals with things I have experienced. I was out and about with my brother today and I got a phone call. I now have an appointment to see a Neuro-Opthalmologist on 8/20 in the afternoon. They originally made me a first available for September 29th and I told the girl that I had been going through this head pressure for 6 months. I told her I drove from Florida and it would be hard for me to be gone that long. ( If push comes to shove I would do it) Thankfully I will see both doctors on the same day. I will let you know what the neuro-ophthalmologist says about head pressure and your eyes and vision. I will be prepared for both visits. @rnlorena