Complete or partial central diabetes insipidus results from (1) destruction of the antidiuretic hormone (ADH)-producing magnocellular neurons in the supraoptic and paraventricular nuclei or (2) interruption of the transport of ADH through their axons, which terminate in the pituitary stalk and posterior pituitary. Diabetes insipidus is relatively common in patients with chronic hypothalamic disorders, being found in approximately 35% of such patients.^[9,10] It also is frequently found in patients with acute insults to the hypothalamus or pituitary stalk, as is seen in vascular accidents and neurosurgical trauma. Obesity and hypogonadism frequently are present in patients with diabetes insipidus due to tumors or infiltrative disorders (Fig. 12-3).

The majority of patients with diabetes insipidus have idiopathic or familial diabetes insipidus associated with gliosis of the supraoptic and …