The Crown says a toddler allegedly killed by her grandmother died of extensive brain injuries caused by a blow or by her head hitting an object.
Joanne Tahuri, 56, is charged with murdering her three-year-old grand-daughter Cherish Tahuri-Wright in February 2009.
Crown prosecutor Ben Vanderkolk told the High Court in Whanganui on Monday the girl was staying at her grandmother's house with a cousin of the same age.
She was rushed to Wellington Hospital with bleeding between her skull and brain, a tear inside her upper lip and a bruised jaw.
Mr Vanderkolk says the accused told police that the toddler had recently fallen twice and been hit by her cousin.
However, he says surgeons agreed that a fall of several metres would have been needed to cause her brain injuries and they could not have been inflicted by another toddler.
