City girl's brain badly damaged, doctor testifies

NASHUA – Rylea Belonga’s brain was in terrible shape by the time she got to Dr. Richard Evans.

Rylea died Jan. 19, 2006, almost two weeks after she collapsed and was rushed to the hospital, and then airlifted to a Boston hospital. In the end, doctors removed several vital organs for transplants, and then sent her 33-inch-long, 25-pound body to Evans for autopsy.

After a full day of examination, followed up by further tests and consultation with other doctors, Evans concluded that Rylea’s death was a homicide, caused by “traumatic head and neck injury, with hypoxic ischemic encephalopathy.”

In other words, her brain was badly swollen because the blood supply had been cut off.

“On a scale of one to 10, where 10 is the worst brain swelling I’ve ever seen, I would give this a 10,” Evans testified Thursday.

There was a three-quarter inch gap between the plates of bone in her skull, where there should have been no gap or a millimeter at most, he said.

It was the brain swelling that killed Rylea, Evans said, and it went along with a cluster of other symptoms: bleeding in the eyes and detached retinas; bleeding along the outside of the left carotid artery; bleeding within the upper spinal cord; and bleeding in the brain and in the durra – the tissue between the brain and skull, he said.

“There were a number of injuries present . . . which lead me to believe that head and neck injuries caused the death,” Evans said.

Ultimately, he concluded that Rylea had suffered some sort of blow to the head – “blunt force trauma,” he said – squeezing or compression to her neck and a shaking or whiplash-type force. Any one of those injuries could have caused the brain to swell, he said, and the swelling killed her brain cells.

“The brain was very soft and was crumbling under my fingertips as I tried to remove it from the skull,” he said. “When cells within the brain are largely dead, the tissue becomes soft and friable.”

Nothing else had happened to Rylea that could explain her injuries, Evans said, so doctors concluded it must have been murder.

“There was not an accidental event that would have explained the autopsy findings,” Evans said.

The events that Rylea’s mother, Nicole Belonga, recounted to detectives wouldn’t have done killed her either, he said, unless they happened with much greater violence than she described. Belonga told police of holding Rylea down firmly while changing a messy diaper, and of Rylea hitting her head on a bookcase as Belonga sent her to a corner for a “time out.”

Belonga, 27, of 65 Alder Drive, is accused of killing her 21-month-old daughter, and faces up to life in prison if convicted of second-degree murder. Belonga appeared distressed by Evans’ testimony, and cried softly at times.

Belonga’s lawyers argue that Rylea suffered the fatal injuries while in the care of her babysitter on the morning that she collapsed, and they called a witness out of turn Thursday to bolster their case.

Jurors and the entire trial staff took a field trip of sorts up to the offices of Conley Reporting and Videoconferencing in Manchester, to hear the testimony of a defense witness, Dr. Patrick Barnes, of California, a neuroradiologist and professor at Stanford University. New Hampshire’s courts don’t have videoconferencing equipment, and Barnes couldn’t travel to New Hampshire, so the trial had to travel.

While Barnes wasn’t able to draw any conclusions, from the images he reviewed, as to what caused Rylea’s brain injuries, he testified that the swelling could have developed within an hour of the initial injuries, much quicker than the six- to 12-hour estimate that the prosecution’s expert had given.