A toddler allegedly murdered by her adoptive father suffered injuries which were "very typical" of babies and children who have been shaken, a court has heard.
Elsie Scully-Hicks, who was aged 18 months when she died, was found to have suffered three separate areas of subdural bleeding when she was admitted to hospital on May 25, 2016, after becoming unresponsive.
Elsie, who had been formally adopted by Matthew Scully-Hicks, 31, and his husband Craig Scully-Hicks, 36, two weeks earlier, died four days later from her injuries which also included a fractured skull, and microfractures to three of her ribs and a fractured left femur.
Matthew Scully-Hicks, a part-time fitness instructor from Delabole, Cornwall, is on trial at Cardiff Crown Court accused of inflicting serious injuries on the toddler at the couple's home in Llandaff, Cardiff, on May 25. He denies murder.
On Wednesday, Dr Neil Stoodley, a consultant neuroradiologist, told jurors he had looked at a CT scan of Elsie's head taken on the day she was admitted to hospital and an MRI scan conducted two days later on May 27, 2016.
Of the CT scan he said it showed evidence of subdural bleeding on both sides of the brain and also at the back around the cerebellum which he said were "unequivocally recent", having occurred in the last seven to ten days.
He said there was also evidence of "small amounts" of recent subarachnoid bleeding and "extensive" hypoxic ischemic brain injury, caused by oxygen deprivation.
Dr Stoodley said Elsie's injures could all be explained as "due to an episode of abusive head trauma that involved a shaking mechanism" and were "a very typical picture of babies of children who have sustained injury as a result of shaking".
He said he believed that would have involved "a repetitive forward and backward movement of the unsupported infant head, so the head going fully forwards and fully backwards on a number of occasions".
"Nobody knows the absolute degree of force that is required to produce such injuries," said Dr Stoodley.
"But (we don't) see the constellation of injuries following normal handling ... in my view it is safe to conclude that the minimum degree of force required is likely to be such that an independent witness would be likely to recognise that the act would be likely to harm the child."
Paul Lewis QC, for the prosecution, asked if Elsie would have been behaving normally after being injured.
Dr Stoodley said there was "likely to be a change in behaviour of the child at the time of the event".
He added: "In my view the causative event is likely to have happened after the last time that the evidence before the court can establish Elsie was behaving normally."
Robert O'Sullivan QC, defending Scully-Hicks, asked if Elsie had been shaken why there was no evidence of soft tissue or bony injury to her neck.
Dr Stoodley said: "It is absolutely the case that in the vast majority of these cases, even looking for demonstrations of soft tissue injury, we don't see it.
"That in my view comes back to the whole question of degree of force."
The court previously heard Scully-Hicks dialled 999 at about 6.20pm on May 25, reporting Elsie was unresponsive, and he could be heard saying "oh my God" and "this is horrible".
The prosecution alleges the fatal injuries were inflicted on Elsie by Scully-Hicks shortly before he called the emergency services and he had also previously been violent towards her.
He is also accused of describing Elsie as a "psycho", "diva" and as "Satan dressed up in a babygro" in messages to friends and family.
Scully-Hicks denies one charge of murder. The trial, expected to last for five weeks, continues.
Consultant ophthalmologist Patrick Watts, who studied images of Elsie's eyes, said she had suffered retinal haemorrhages, or bleeding, in both eyes.
He said the superficial bleeding was up to one week old while the deeper haemorrhages could be up to six weeks old.
He said the bleeding could have been caused "if the eye was shaken vigorously" which could cause the jelly in the eye to pull away from the retina.
Mr Lewis asked: "From what you saw might that sort of shaking mechanism explain what you saw in Elsie's eyes?"
Mr Watts said it "certainly" would.
The trial was adjourned to 10.30am on Thursday.
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