Live coverage of Thornaby toddler Isabelle Welsh murder trial - Day 11
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By Graeme Hetherington
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12:56pm 10/07/26
Hearing adjourned
The hearing has adjourned for the week.
Mrs Justice Norton has told the jury that they will not be required on Monday or Tuesday and the trial will resume on Wednesday when the prosecution is expected to conclude its case.
12:30pm 10/07/26
Cross examination
Mark McKone KC, representing Alexandra Walker, is now cross examining Dr Duplessis.
He asks about the impact of the older head injury and whether she would have been lethargic.
The doctor says there is a likelihood that she could have shown signs of lethargy and could have started to improve.
Mr McKone asks whether Isabelle could have watched tv or eaten her breakfast after suffering the fatal head injury. Dr Duplessis simply replies: "No."
12:00pm 10/07/26
Evidence conclusion
Dr Duplessis says it is clear that the skull fracture was the cause of death and ruled out that it was caused accidentally.
11:58am 10/07/26
Loss of consciousness
Dr Duplessis says she may not have lost consciousness but she would be clearly very unwell and she would immediately deteriorate.
"If she wasn't in a coma from the outset, she would have been unresponsive and floppy," he says.
He tells the jury that it is impossible to accurately determine the time the fatal injury was inflicted as they could have been unconscious for several hours before they go into cardiac arrest.
11:53am 10/07/26
Fatal injury
Dr Duplessis says she suffered a major impact to the skull evident from the fracture but there must have also been very excessive motion of the spine and the head on the spine.
He says there could have been two separate incidents - head impact and violent shaking - but says they could have happened at the same time.
The jury hears there were fractures to Isabelle's limbs being gripped which shows she could have been held and swung against a solid object.
"I would favour that she was gripped by the limbs and flung against a surface," he says. "But it is also possible that there were two events - I can't be certain."
He says shaking is rarely fatal for children of Isabelle's age - a two-year-old would be more physically capable of dealing with the shaking.
11:46am 10/07/26
Brain damage
Dr Duplessis says Isabelle was not getting oxygen or blood to the brain after she suffered a heart attack.
He says she could have started suffering brain damage before the paramedics were called.
"There could have been a period where she suffered critical or fatal brain damage before he paramedics arrived," he says.
The jury hears that the damage to her brain was so severe that an emergency operation to relieve pressure could not have saved her life.
The doctor confirms that there was evidence to two incidents of damage to Isabelle's brain but the event on September 13 was what caused the toddler's death.
11:39am 10/07/26
Spinal chord
Dr Duplessis says there was no response to the injury suffered to Isabelle's spinal column meaning it occurred no more than 48 hours before death.
He says if you find bleeding around the spinal column it rarely occurs in an accidental fashion and shows she was victim to a major non-accidental event causing damage to her head and spine.
The jury hears how there was also evidence of bleeding on the nerve roots - some were from within 48hrs but some were older.
Richard Wright KC asks whether the bleeds could have occurred at the same time as the spinal fractures which Isabelle suffered several days before she died.
The doctor agrees.
The doctor says there was also evidence of older fractures to the top of Isabelle's spine.
11:28am 10/07/26
Older injury
Dr Duplessis says the earlier injured occurred in the days or weeks before Isabelle died.
He says he was unable to say whether that one was an accidental or non-accidental injury.
The jury hears how the doctor inspected the 'bruising' under a microscope which determined it occurred around four days before her death when there was another impact on her head.
He says 'we are not talking about extreme level of force' but it was more than an every day knock to the head.
The doctor says the fibres are like electrical wires which transmit information around different parts of the brain.
The corpus callosum is a section of nerve fibres that connect the brain's left and right hemispheres to enable them to communicate.
He says there was damage to the corpus callosum which was caused by shaking or the impact from the skull fracture.
11:19am 10/07/26
Non-accidental injury
Dr Duplessis says there is strong evidence that the bleed on the brain was a non-accidental injury.
He says there wasn't just one area affected by bleeding which tends to mean that they were not caused in an accident unless Isabelle fell from a building, a road traffic collision or crush injuries.
The jury hears that there was no evidence to indicate any of those situations occurred before Isabelle's death.
"There can be no doubt that this was a traumatic injury," he says.
The jury hears how a vein had torn from the brain resulting in bleeding inside the skull within 24hrs of her death. He says there was also an older bleed discovered during his examinations.
"Looking with the naked eye I could see discolouration which was different from the fresh injury. It was something that might be slightly older because of the change in colour," he says.
11:05am 10/07/26
Head injuries
Dr Duplessis says the bleed on the brain was up to 48 hours but it could be just an hour old as well.
He confirms that it is not days old because there is no evidence of the body natural response to the injury.
The medical expert says there was bleeding in multiple areas of the brain and he ruled out any natural cause for the injury.
He says there is evidence that she suffered traumatic injury due to the multiple bleeds.
"It's likely a non-accidental event but an event caused by forceful movement of the head," he says.
The doctor tells the jury that a rise in pressure caused by the bleed and blood clot can become life-threatening adding that it doesn't take a great deal of blood to cause death.
10:48am 10/07/26
First witness
Dr Daniel Duplessis, a consultant neuropathologist, is the first witness to give evidence today.
He studied the damage to Isabelle's brain and spinal chord.
Jurors hear how he inspected her brain with the naked eye and under specialist microscopes.
He says he examined a blood clot that was essential for him to be able to age the damage to the brain.
10:42am 10/07/26
Trial resumes
You can read a round up of yesterday's evidence here -
Toddler Isabelle Welsh suffered sexual and physical abuse, trial hears