The massive brain injuries from which baby Matthew Eappen died could have been caused up to two days before he was allegedly murdered by the nanny Louise Woodward, a pathologist told her trial in the United States yesterday.
Dr Umberto De Girolmi was the third prosecution medical witness to admit that the nine-month-old baby's brain haemorrhage could have been suffered before the day he was admitted to Boston Children's Hospital in an irreversible coma.
The doctor also said there was too much brain damage to find evidence to support the prosecution's claim that the baby had been shaken violently before he died.
A consultant neuropathologist, Dr De Girolmi had looked for signs of old injury or disease when he microscopically examined the baby's brain, he told the Middlesex Superior Court in Cambridge, Massachusetts.
He had found none - but it was impossible to be more precise about when the fatal injury happened other than that it was within a week of Matthew's death.
"The changes to the brain were within a week, they are not older than a week," said the doctor.
The baby died five days after his admission to hospital on 4 February this year.
The defence claims his brain injury could have happened earlier and gone undetected before it started re-bleeding either spontaneously or because of mild jarring.
Dr De Girolmi told defence lawyer Barry Scheck that the injury could date back to February 2 - two days before Miss Woodward, 19, called emergency services in panic to say Matthew was barely breathing.
The prosecution alleges that Woodward, of Elton, near Chester, shook him violently and slammed his head against a hard surface in a bitter, frustrated rage because of his crying and her unhappiness with her job with his parents Deborah and Sunil Eappen in Newton, near Boston.
Woodward denies first degree murder which carries a sentence of life without parole.
The pathologist who carried out the post-mortem examination on Matthew said yesterday he did not believe the baby had been violently shaken because of the lack of haemorrhage in the neck muscles and the fact there were no bruises on his neck and ribs to show he had been grabbed.
Mr Scheck asked Dr De Girolmi whether too much of the brain had been destroyed to find the shearing of the brain tissue which would indicate shaking.
The pathologist replied: "I agree with you."
Shortly before the start of yesterday's hearing Woodward was in tears in the courtroom.
She had to be comforted by her defence lawyers but quickly regained her composure before the start of the proceedings.Reuse content