A TOP doctor told a court she believed a five-month-old boy allegedly shaken to death by his child minder may have collapsed because of a pre-existing problem.

Professor Helen Whitwell told a manslaughter trial jury that baby Anil Joshi died from swelling of the brain as a result of damage due to lack of blood and oxygen getting to the brain.

She said: "There was no evidence of trauma to the brain itself."

Asked by defence QC Graham Wood why Anil might have collapsed on January 8, 2003, at his Bolton home, Professor Whitwell said it may have been as a result of the effect of chronic sub-dural haematoma.

She said she believed the haematoma, a collection of blood, had been present for several days, more than three days. She said: "It is important because it may have a bearing on the issue of susceptibility to re-bleeding."

Professor Whitwell, a consultant forensic pathologist, said it was also possible that Anil collapsed while at the home of childminder, Rebecca Wilson, as a result of injury to the crano-cervical area at the back of the head causing his breathing to stop or him becoming floppy.

She said: "The current accepted view is that it is more than normal handling required to produced damage in this area. In some cases you see very few nerve fibres damaged and my own view would be it is really unclear as to precisely how much force is required.

"Where you have sub-dural haematoma, it is unclear how much trauma or any at all is required to produce fresh bleeding," she added

Wilson, aged 33, of Willow Close, Deane, Bolton, has told Liverpool Crown Court that Anil had been cranky that day, and had also been difficult over the previous few days. She claims he had not wanted his food and she played games with him including bouncing him up and down as he lay on her knee and his unsupported head fell backwards and he suddenly became floppy.

The prosecution, however, claimed that she lost her temper and in frustration violently shook the little boy which caused him to collapse. Wilson, a mother-of-two, denies the manslaughter of Anil and also assaulting him causing actual bodily harm the previous day when he suffered a mark around his eye and the bridge of his nose.

Asked how much evidence there was for the concept of re-bleeding, Professor Whitwell said that it was well recognised in adults that re-bleeding could occur when there was chronic sub-dural haematoma, sometimes without additional trauma.

"Can you, from a pathological view, exclude Rebecca Wilson's account?"asked Mr Wood.

"No," she replied.

Proceeding