The most common cause of cranial diabetes insipidus is actual trauma to the area around the pituitary. Lesions that cause diabetes insipidus need to involve the median eminence as well as the posterior pituitary. This is based on evidence that sufficient release of ADH can occur from the median eminence even with complete transection of the pituitary stalk.
In almost one third of cases, no cause can be found for diabetes insipidus. There does seem to be some genetic factor that has not yet been identified. The argument for a genetic factor is supported be a very rare syndrome known as Wolfram syndrome (DIDMOAD). In Wolfram syndrome, diabetes insipidus is associated with diabetes mellitus type 1, atrophy of the optic nerves and deafness. Very little is known of the cause or pathophysiology of this condition.
A list of the causes of cranial diabetes insipidus is given below: