What can cause pain in top of head, vomiting bright red blood in a 59 yr old 214 lb male with hi blood pressure?

Hematemesis: If someone is vomiting bright red blood they should get to the emergency room as soon as possible. There are many possible causes none of them good.

A bit much: Vomting can cause a headache and a headache can cause vomiting. But bright red blood while probably benign can be an important tear in the esophagus and should be checked out quickly. I hope your are 6'4" or have a 34" or smaller waist for that weight. See a good internist pdq.