Assistant Professor of

CLINICAL

Justin M. Brown, M.D.
Michael R Chicoine, M.D.
William S Coxe, M.D.
Ralph G Dacey, Jr., M.D.
Joshua L Dowling, M.D.
Robert L Grubb Jr., M.D.
Jeffrey R Leonard, M.D.
Eric C Leuthardt, M.D.
David D Limbrick, M.D., PhD.
T.S. Park, M.D.
Keith M Rich, M.D.
Paul Santiago, M.D.
Matthew D Smyth, M.D., FACS, FAAP
Todd J Stewart, M.D.
Neill M Wright, M.D.
Gregory J Zipfel, M.D.

RESEARCH

Hans H Dietrich, Ph.D.
Jeffrey M Gidday, Ph.D.
Henry Han, Ph.D.
Thomas A Woolsey, M.D.

JOINT

Dewitte Cross III, M.D.
Colin Derdeyn, M.D.
Robert Drzymala, Ph.D.
Mokhtar Gado, M.D.
Gerald P Linette, M.D., Ph.D.
Christopher Moran, M.D.

Department of Neurosurgery
Washington University
School of Medicine
Campus Box 8057
660 S. Euclid Ave.
St. Louis, MO 63110
(314) 362-3577

David D Limbrick, M.D., PhD.

Assistant Professor of
Neurological Surgery
and Pediatrics

Washington University School of Medicine
Department of Neurological Surgery
660 S. Euclid Avenue
Campus Box 8057
St. Louis, MO 63110, U.S.A.

Administrative Office: (314) 454-2810
Fax: (314) 454-2818
Email: limbrickd@wustl.edu

Clinical Interests:

Pediatric neurosurgery, epilepsy surgery, neuro-endoscopy, hydrocephalus, pediatric brain tumors, deep brain stimulation, radiosurgery, pediatric spine

Research Interests:

Neuronal membrane physiology, patch-clamp electrophysiology, CSF proteomics, hydrocephalus, neuroprosthetics, brain tumor biology

Education:

BS, Biology, College of William and Mary
Williamsburg, Virginia
1992-1995

MD,Medical College of Virginia, Virginia Commonwealth University
Richmond, Virginia
1995-2001

PhD, Medical College of Virginia, Virginia Commonwealth University
Richmond, Virginia
1995-2001

Residency:

Intern, General Surgery
Washington University School of Medicine
St. Louis, Missouri
2001-2002

Resident, Neurological Surgery
Barnes-Jewish Hospital &
Washington University School of Medicine
St. Louis, Missouri
2002-2007

Senior Registrar, Neurological Surgery
Beaumont Hospital
Dublin, Ireland
2005

Chief Resident, Neurological Surgery
Barnes-Jewish Hospital &
Washington University School of Medicine
St. Louis, Missouri
2006-2007

Fellowship:

Fellow, Pediatric Neurological Surgery
St. Louis Children’s Hospital &
Washington University School of Medicine
St. Louis, Missouri
2007-2008

Hospital Appointments:

St. Louis Children's Hospital, St. Louis, Missouri
Barnes Jewish Hospital, St. Louis, Missouri

Medical Licensure:

Missouri

Board Certification:

Board eligible American Board of Neurological Surgery

Publications:

Limbrick, D.D.J., Churn, S.B., Sombati, S., and DeLorenzo, R.J. Inability to restore resting intracellular calcium levels as an early indicator of delayed neuronal cell death. Brain Research 690: 145-56, 1995.
Churn, S.B., Limbrick, D., Sombati, S., and DeLorenzo, R.J. Excitotoxic activation of the NMDA receptor results in inhibition of calcium/calmodulin kinase II activity in cultured hippocampal neurons. Journal of Neuroscience 15: 3200-14, 1995.
DeLorenzo, R.J. and Limbrick, D.D.J. Effects of glutamate on calcium influx and sequestration/extrusion mechanisms in hippocampal neurons. Advances in Neurology 71: 37-46, 1996.
Pal, S., Sombati, S., Limbrick, D.D.J., and DeLorenzo, R.J. In vitro status epilepticus causes sustained elevation of intracellular calcium levels in hippocampal neurons. Brain Research 851: 20-31, 1999.
Pal, S., Limbrick, D.D.J., Rafiq, A., and DeLorenzo, R.J. Induction of spontaneous recurrent epileptiform discharges causes long-term changes in intracellular calcium homeostatic mechanisms. Cell Calcium 28: 181-93, 2000.
Limbrick, D.D.J., Pal, S., and DeLorenzo, R.J. Hippocampal neurons exhibit both persistent Ca2+ influx and impairment of Ca2+ sequestration/extrusion mechanisms following excitotoxic glutamate exposure. Brain Research 894: 56-67, 2001.
Pal, S., Sun, D., Limbrick, D., Rafiq, A., and DeLorenzo, R.J. Epileptogenesis induces long-term alterations in intracellular calcium release and sequestration mechanisms in the hippocampal neuronal culture model of epilepsy. Cell Calcium 30: 285-96, 2001.
Limbrick, D.D.J., Sombati, S., and DeLorenzo, R.J. Calcium influx constitutes the ionic basis for glutamate-induced extended neuronal depolarization in hippocampal neurons. Cell Calcium 33:69-81, 2003.
Limbrick, D.D.J., Wright, N.M. Verification of nerve root decompression during minimally-invasive lumbar microdiskectomy: a practical application of surgeon-driven evoked EMG. Minimally Invasive Neurosurgery 48:273-7, 2005.
Limbrick, D.D.J. and Park, T.S. Occult hydrocephalus in children with cerebral palsy. Neurosurgery 58(3):E590, 2006.
Mangano, F.T., Limbrick, D.D.J., Leonard, J.R., Park, T.S., and Smyth, M.D. Simultaneous image-guided and endoscopic navigation (SIGEN) without rigid skull fixation: application in infants: technical case report. Neurosurgery 58: ONS-E377, 2006.
Smyth, M.D, Limbrick, D.D.J., Ojemann, J.G., Zempel, J., Robinson, S., O’Brien, D.F., Saneto, R.P., Goyal, M., Appleton R.E., Mangano, F.T., and Park, T.S. Surgical outcomes for temporal lobe epilepsy and hippocampal sclerosis in young children. Journal of Neurosurgery 106:205-10, 2007.
Deshpande, L.S., Limbrick, D.D., Sombati, S., and Delorenzo, R.J. Activation of a novel injury-induced calcium permeable channel that plays a key role in causing extended neuronal depolarization and initiating neuronal death in excitotoxic neuronal injury. Journal of Pharmacology and Experimental Therapeutics 322:443-52, 2007.
Schalk, G., Kubanek, J., Miller, K.J., Anderson, N.R., Leuthardt, E.C., Ojemann, J.G., Limbrick, D., Moran, D., Gerhardt, L.A., and Wolpaw, J.R. Decoding two-dimensional movement trajectories using electrocorticography signals in humans. Journal of Neural Engineering 4:264-75, 2007.
Limbrick, D.D.J., Leonard, J.C., Wright, N.M., Leonard, J.R. Cervical Spine Trauma in Children, Including Spinal Cord Injury Without Radiographic Abnormality, in Kim, D., Betz, R., Huhn, S., and Newton, P. (eds) Surgery of the Pediatric Spine. Thieme Medical Publishers, New York, 2008, p.489-500.
Limbrick, D.D.J., Lusis, E.A., Chicoine, M.R., Simpson, J.R., Rich, K.M., Dacey, R.G., Dowling, J.L., Grubb, R.L., Filiput, E.A., Drzymala, R.E., Mansur, D.B., and Malyapa, R.S. Combined surgical resection and stereotactic radiosurgery for treatment of cerebral metastases. Surgical Neurology 2008 Apr 17. [Epub ahead of print].
Kiehl, E., Stojadinovic, S., Malinowski, K.T., Limbrick, D., Jost, S.C., Rubin J.B., Deasy, J.O., Parikh, P.J., Lowe, D.A., and Hope, A.J. microRT: CNS Radiotherapy. Medical Physics 35: 4735-43, 2008.
Miller, J.H., Limbrick, D.D.J., Callen, M., and Smyth M.D. Spontaneous resolution of Chiari type I malformation in monozygotic twins. J Neurosurg Peds 2: 317-19, 2008.
Goldhoff, P.*, Warrington, N.*, Limbrick, D.D.J.*, Hope, A., Woerner, B.M., Jackson, E., Perry, A., Piwnica-Worms, D., and Rubin, J.B. Targeted inhibition of cyclic AMP phosphodiesterase-4 promotes brain tumor regression. Clin Cancer Res 12: 7717-25, 2008.
Behdad, A.,* Limbrick, D.D.J.,* and Smyth, M.D. Epilepsy surgery in children with seizures arising from the Rolandic cortex. Epilepsia In press.
Lipira, A., Limbrick, D., Haughey, B., Custer, P., and Chicoine, M. Titanium mesh reconstruction to maintain scalp contour after temporalis musculo-fascial flap reconstruction of middle fossa floor: A technical note and report of two cases. Skull Base In press.
Johnston, J.M., Limbrick, D.D.J., Ray, W.Z. and Park, T.S. Isolated cerebellar Rosai-Dorfman granuloma mimicking Lhermitte-DuClos: Case presentation and review of the literature. J Neurosurg Peds In press.
Limbrick, D.D.J., Behdad, A., Derdeyn, C.P., Zipfel, G.J., and Santiago, P. Traumatic avulsion of the ophthalmic artery mimics aneurysmal subarachnoid hemorrhage and clinical course. Journal of Neurosurgery In press.
Limbrick, D.D.J., Narayan, P., Powers, A.K., Ojemann, J.G., Park, T.S., Bertrand, M., and Smyth, M.D. Hemispherotomy: Efficacy and analysis of seizure recurrence. J Neurosurg Peds In press.

Churn, S.B., Limbrick, D., and DeLorenzo, R.J. Possible role of excitotoxicity-induced inhibition of CaM kinase II activity in delayed neuronal death. Soc. Neurosci. 19: 1777, abstr. 729.3, 1993.
Churn, S.B., Limbrick, D., and DeLorenzo, R.J. Glutamate-induced inhibition of CaM kinase II activity correlates with sustained intracellular calcium. Soc. Neurosci. 20: 267, abstr. 120.8, 1994.
Limbrick, D.D.J., Pal, S., and DeLorenzo, R.J. Hippocampal neurons exhibit both a persistent influx of extracellular Ca2+ and an impairment of Ca2+ sequestration/extrusion mechanisms following excitotoxic glutamate exposure. Soc. Neurosci. 24: 1826, abstr. 724.16, 1998.
Limbrick, D.D.J., Pal, S., Sombati, S., and DeLorenzo, R.J. Evaluation of glutamate-induced damage to neuronal calcium regulation systems. Soc. Neurosci. 25: 2234, abstr. 890.2, 1999.
Mangano, F.T., Limbrick, D.D.J., Leonard, J.R., Park, T.S., Smyth, M.D. A Novel Technique Involving Simultaneous Image-Guided and Endoscopic Surgical Navigation Without Rigid Skull Fixation in Infants. AANS/CNS Section on Pediatric Neurological Surgery, San Francisco, CA, 2004.
Lusis, E.A., Limbrick D.D.J., Chicoine, M.R., Simpson, J.R., Rich, K.M., Dacey, R.G., Dowling, J.L., Grubb, R.L., Filiput, E.A., Drzymala, R., Malyapa, R.: Combined Surgical Resection And Gamma Knife Radiosurgery For Cerebral Metastases. Society for Neuro-Oncology, Toronto, 2004.
Limbrick, D.D.J., Wright, N.M. Verification of nerve root decompression during minimally-invasive lumbar microdiskectomy: a practical application of surgeon-driven evoked EMG. AANS, New Orleans, LA, 2005.
G. Schalk, J. Kubanek, K. J. Miller, N. Anderson, E. C. Leuthardt, J. G. Ojemann, D. Limbrick, D., Moran, L. A. Gergard, J. R. Wolpaw; Decoding two-dimensional movement trajectories from electrocorticographic signals in humans. Soc. Neurosci., Atlanta, GA, October, 2006.
Kiehl, E., Stojadinovic, S., Malinowski, K.T., Limbrick, D., Jost, S.C., Rubin J.B., Deasy, J.O., Parikh, P.J., Lowe, D.A., and Hope, A.J. Conformal murine CNS radiotherapy using microRT. ICCR, Toronto, Ontario, Canada, June 2007.
Limbrick, D.D.J., Narayan, P., Johnston, J.J., Ojemann, J.G., Park, T.S., and Smyth, M.D. Outcomes following hemispherotomy: the St. Louis Children’s Hospital experience. Annual Meeting for the International Society for Pediatric Neurosurgery, Liverpool, UK, September 2007.
Goldhoff, P., Warrington, N., Limbrick, D., Hope, A., Woerner, M., Jackson, E., Piwnica-Worms, D., and Rubin, J. Phosphodiesterase type 4 drives brain tumor growth in vivo. Society for Neuro-Oncology, Dallas, TX, November 2007.
Limbrick, D.D.Jr., Narayan, P., Ojemann, J.G., Park, T.S., and Smyth, M.D. Seizure-freedom and complication rates following functional hemispherotomy. AANS/CNS Section on Pediatric Neurological Surgery, Miami, November, 2007.
Limbrick, D.D.J., Warrington, N., Goldhoff, P., Hope, A., Woerner, B.M., Jackson, E., Rao, M., Piwnica-Worms, D., Leonard, J.R., and Rubin, J.B. Phosphodiesterase type 4 regulates the growth of malignant brain tumors in vivo. AANS/CNS Section on Pediatric Neurological Surgery, Miami, November, 2007.
Behdad, A., Limbrick, D.D.Jr., and Smyth, M.D. Epilepsy surgery in children with seizures arising from the Rolandic cortex. AANS/CNS Section on Pediatric Neurological Surgery, Miami, November, 2007.
Lee, A., Van Pelt, A., Kane, A., Limbrick, D., and Smyth, M.D. Comparison Of Perceptions And Treatment Practices Between Neurosurgeons And Plastic Surgeons For Infants With Deformational Plagiocephaly. AANS/CNS Section on Pediatric Neurological Surgery, Miami, November, 2007.
Limbrick, D.D.Jr., Johnston, J., Ojemann, J.G., Park, T.S., and Smyth, M.D. Functional hemispherotomy: rates of seizure-freedom and analysis of seizure recurrence. Neurosurgery in the Rockies. Beaver Creek, Colorado, February, 2008.
Limbrick, D.D.J., Kaufman, C., Ojemann, J.G., and Smyth, M.D. Tracing the Evolution of Epilepsy Surgery Through the Career of Sydney Goldring. AANS, Chicago, 2008.

Washington University Physicians	Washington University	Barnes-Jewish Hospital	St. Louis Children's Hospital