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A post-mortem examination found Elsie had previous and recent bleeding on both sides of her brain.
Consultant neuroradiologist Dr Neil Stoodley said he believed Elsie suffered "abusive head trauma that involved a shaking mechanism."Other experts said Elsie's collapse days before her death could have been due to suffering a severe head injury, and found she had suffered injuries to her skull, left femur and three of her ribs between three to five days before her death.
A stay-at-home father accused of murdering his adopted baby daughter referred to her as 'Satan dressed up in baby grow,' a court heard.
Matthew Scully-Hicks, 31, is accused of killing 18-month old Elsie after 'assaulting and abusing' her over several months.
On December 16 2015, while Mr Scully-Hicks was at work, Elsie sustained a bruise to the left hand side of her forehead.
A health visitor advised Scully-Hicks to take Elsie for treatment on December 21. On January 18 2016, Elsie suffered another bruise to her head.
Stay-at-home father Matthew Scully-Hicks is accused of killing his 18-month-old adopted child Elsie after 'assaulting and abusing' the tragic youngster over a perviod of several months.'He said he had then seen Elsie at the top of the stairs, that the baby gate had then opened and that Elsie had tumbled down the stairs,' Mr Lewis said.
Dr Nia John, a consultant paediatrician, said it would be 'unusual' to suffer two such fractures in the same fall, the court heard.
Mr Lewis said: "The weight of medical evidence is likely to prove that in addition to the recent bone injuries Elsie had suffered, her catastrophic brain injuries and retinal haemorrhages must have been as a result of trauma she suffered immediately before her collapse and the 999 call."Elsie was then of course just 18-months -old.
She could not have inflicted such dreadful injuries on herself."The court heard one expert could not rule out all of Elsie's brain and spine abnormalities were caused "as a consequence of a single event".
Elsie's injuries were considered to be 'consistent with a fall downstairs' and she was discharged home after four hours in hospital, Mr Lewis said.
Then, on May 25 last year, Scully-Hicks phoned an ambulance telling an operator Elsie had become 'floppy and limp' while he changed her for bed.