From: http://books.nap.edu/html/marimed/ch4.html
Migraine Headaches
There is clearly a need for improved migraine medications. Sumatriptan (Imitrex) is the best available medication for migraine headaches, but it fails to abolish migraine symptoms in about 30% of migraine patients.118,147 Marijuana has been proposed numerous times as a treatment for migraine headaches, but there are almost no clinical data on the use of marijuana or cannabinoids for migraine. Our search of the literature since 1975 yielded only one scientific publication on the subject. It presents three cases of cessation of daily marijuana smoking followed by migraine attacks--not convincing evidence that marijuana relieves migraine headaches.43 The same result could have been found if migraine headaches were a consequence of marijuana withdrawal. While there is no evidence that marijuana withdrawal is followed by migraines, when analyzing the strength of reports such as these it is important to consider all logical possibilities. Various people have claimed that marijuana relieves their migraine headaches, but at this stage there are no conclusive clinical data or published surveys about the effect of cannabinoids on migraine.
However, a possible link between cannabinoids and migraine is suggested by the abundance of cannabinoid receptors in the periaqueductal gray (PAG) region of the brain. The PAG region is part of the neural system that suppresses pain and is thought to be involved in the generation of migraine headaches.52 The link or lack thereof between cannabinoids and migraine might be elucidated by examining the effects of cannabinoids on the PAG region.110 Recent results indicating that both cannabinoid receptor subtypes are involved in controlling peripheral pain15 suggest that the link is possible. Further research is warranted.
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