Horrible headache, nothing like I have felt before. Should I get a second opinion?

Dear Ask The Doctor: I am a 33 year old female. History of migraines, but haven't had any in many years. Sunday, I ended up with a headache that came on suddenly. The pressure in my brain was something like a horror movie. I would rate a 10 out of 10. I was stress, as my husband and I were arguing. This headache had NO warning signs. It left me screaming and wanting to bang my head on the wall. The only thing that calmed me was for my husband to hold my head in a headlock and put as much pressure as possible and rub the base of the back of my skull, also with as much pressure as he could. We believe it lasted around 45 mins. I was nauseous, but never threw up. I went to my PCM on Monday and had a fever of 99.1 and bp of 130 over 80. Both were high for me. She did a simple exam of my eyes, throat, nose and lungs and said since I was there and walking around that I was probably fine, but to go straight to the ER if it happens again. It's 2 days later and I'm completely exhausted and fearful that I will have anything close to that headache again. Should I seek a second opinion or is this headache something that should be ignored like my PCM did?

Dear Jennifer: Migraines may be brought about by stress, anxiety, certain foods. In your case I think that stress was a triggering factor for the headache. It will be helpful if you keep a headache diary and note every detail about the headache like timing, how long it lasted? what caused you relief? nausea? vomiting?

There are many medications that prevent an attack from happening and give symptomatic relief. You may need to consult your doctor for medication like Triptans or ergotamines. If you notice that your headaches get worse, or appear when you wake up, you have difficulty in speaking or moving a part of the body, you must see your doctor immediately.