The possibility that Henri van Breda faked being unconscious after a gruesome axe attack at his family's home, could not be excluded, the court heard. Picture: Catherine Rice/ANA

Cape Town - The possibility that 22-year-old Henri van Breda faked being unconscious for two hours and 40 minutes after a gruesome axe attack at his family's Stellenbosch home, could not be excluded, the Western Cape High Court heard on Monday.

The defence's second witness neurosurgeon Dr Michael du Trevou testified that it was "impossible to exclude malingering" or feigning illness. He said "post traumatic amnesia was most likely", while a loss of consciousness was unlikely.

"This kind of amnesia is related to physical injury. As a result there is a disturbance to the brain that leads to loss of memory".

Van Breda has pleaded not guilty to the January 2015 murders of his mother, father and brother as well as the attempted murder of his sister Marli, who was 16-years-old at the time.

The accused claims that an intruder, armed with an axe and knife, and wearing dark clothing, a balaclava and gloves was behind the attacks. Van Breda said, in his plea explanation, that during the pursuit of the attacker he lost his footing and fell down the stairs. He added: "I do not know what made me fall, but my fall was quite severe". 

After the attacker fled, and trying to phone his girlfriend without success, the accused said he went up the stairs, where he could hear his brother Rudi in the bedroom. On the middle landing towards the top, he saw Marli moving, while his mother was not moving.

"I then lost consciousness. I am unsure whether this was due to shock or to the injuries that I sustained when I fell down the stairs, or a combination of both".  

Earlier in the trial, State witness and forensic pathologist Dr Marianne Tiemersma disputed Van Breda's claims that he had been unconscious.

Van Breda claimed  that he only contacted emergency services several hours after the attack because he had been unconscious, but when he was later examined by a doctor, he had shown no signs of concussion.

Dr Tiemensa said he would have had to lose 900ml to a litre of blood to lose consciousness. 

A concussion would have only caused a loss of consciousness for a couple of seconds, a minute at most whereas such a lengthy period of unconsciousness would have indicated serious brain injury. But, Du Trevou said that was "incorrect".

The defence's second witness neurosurgeon Dr Michael du Trevou testified that it was "impossible to exclude malingering" or feigning illness. Picture: Catherine Rice/ANA

"In cases where a patient is fully conscious afterwards, they would not necessarily have had a brain injury".

Tiemensma further testified that if he had lost consciousness from an emotional shock, it also would not have lasted for more than a minute. Du Trevou conceded that if Van Breda had been unconscious from a "fainting attack" it would not have lasted so long, "unless he fell and hit his head". 

He testified that he assumed Van Breda had hit his head, causing the bruising on the left side of his forehead, and causing a "minor brain injury". He also told the court that an MRI scan done on Van Breda "was normal expect for two minor congenital abnormalities" which he said would have played no role. 

In his report Du Trevou said: "It is not possible to determine, ex-post facto, whether the accused had lost consciousness or whether he merely lost recall of the incident. The mere fact that no evidence of a prior injury is visible on the MRI scans, does not exclude the possibility that he had lost consciousness or recall of the events subsequent to hitting his head".

Du Trevou also testified about the position older brother Rudi was found in. According to Van Breda's plea explanation Rudi was attacked on his bed, but his body was found a metre and a half away, next to the bathroom door. 

He told the court that the sound of Rudi "gurgling" from blood or saliva at the back of his throat would have been possible up until the time of his death, as would have been "some limited movement" since "neither the right nor probably the left motor cortex were injured". 

It was also possible that Rudi "suffered a convulsion prior to his death". 

Senior State prosecutor, Susan Galloway, said the duvet from Henri's bed had "ended up rolled up on top of Rudi's blood and that would have been a goal directed move". 

Du Trevou agreed and said: "I don't know his level of confusion, consciousness and shock at that stage. But, it would have been possible to make purposeful movements".

He further told the court that when someone can't remember what happened prior to losing consciousness that is retrograde amnesia, and is indicative of a more serious brain injury.  

Marli suffered from retrograde amnesia, and because she has not been able to recall the events of that night, has not been able to testify in the trial.