A PATHOLOGIST said if a fatal head injury sustained by a Cwmbran baby was accidental, the extent of her injuries will make it the first ever case of its kind, a court heard.

Dr Colin Smith, a neuropathologist, said in the trial of Mark Jones, accused of murdering his one-month-old granddaughter Amelia Rose Jones, that there are no recorded cases of accidental head injuries causing “this constellation of pathology”.

Amelia died aged 41 days on November 12, 2012 after suffering a “catastrophic head injury”. Jones, 45, of no fixed address, denies her murder.

Dr Smith told Newport Crown Court yesterday: “There are very few cases of subdural bleeding in an infant’s brains and by far, the most common cause is trauma.

“There’s considerable literature around accidental infant head injury, some of that literature will also address low level falls.”

He told the jury that infant head injury is “very rare”, that a significant head injury from low level falls is “very rare” and fatal head injuries from low level falls are “extremely rare”.

“There isn’t a single case of a fatal infant low level fall which is pathologically equivalent to this case,” Dr Smith said.

“I’ve been practicing medicine long enough that I know never to say ‘never say never’ but I think we have to step back and see if you accept this is an accidental head injury, it’s the first ever with this constellation of pathology.”

When cross-examined, Dr Smith however did admit that he could not make a distinction between non-accidental and accidental injuries.

Dr Susan King, a consultant paediatrician radiologist, said rib fractures in babies of Amelia’s age are “extremely unusual”.

“The only times when you might see a fracture from an accident would be if a child had been crushed, say an adult falling on them or fallen down a flight of stairs”, she said. “You can occasionally see them after CPR.”

Dr King added that “hardly ever" do children get skull fractures from short falls.

A consultant ophthalmic pathologist Dr Richard Bonshek told the court that after studying slides sent to him by pathologist Dr Deryck James, he saw bleeding in the tissue in the eye which was “very suggestive of severe trauma”.

Prosecuting barrister Paul Lewis QC asked whether shaking Amelia in an attempt to revive her might have resulted in an abnormality in her eyes.

"It's something that has been thought about and considered by doctors at some length,” Dr Bonshek replied. “Basically the conclusion was its highly unlikely it would cause retinal haemorrhage."

The doctor cited one case that had led to mild haemorrhaging when a father had shaken his five-month-old baby who was choking.

In cross-examination, defence barrister Roger Thomas QC asked if the injuries could occur if the baby was dropped from waist or chest height.

Dr Bonshek said: "If there was some bizarre accident, then maybe.”

Proceeding.