Well, an isolated event can happen.

Do record the details of this attack someplace, in case you need them later, including pain quality (pulsating or steady), attack duration, meds used and effectiveness, other sx (eg nausea, heightened senses, sensory disturbances, other neurological sx).

There is a type of headache called an "ice pick headache" but these last seconds, not hours. His attack sounds similar to a migraine but migraine onset after age 50, although possible, is rare. If this isn't a one-time thing, he really must be checked out.

His bp did not sound that high, and it seems an unlikely causal factor. What does his typical bp run? A slight elevation is conceivable due to the pain (stress response).

waves