A 29-year-old woman presents to the ED with vertical diplopia after striking her head on a low doorway. Vital signs: BP 128/82, HR 88, RR 16, Temp 37.2°C, SpO2 98% on room air. Symptoms worsen when reading and descending stairs. She compensates by tilting her head away from the affected side. Neuroimaging reveals no acute findings. She denies hearing loss or facial weakness. Which cranial nerve is most likely injured?

  1. A)Facial nerve
  2. B)Trochlear nerveGABARITO
  3. C)Oculomotor nerve
  4. D)Mandibular division of trigeminal nerve
  5. E)Abducens nerve

Explicação

The trochlear nerve innervates superior oblique, which depresses the adducted eye. Patients with CN IV palsy develop vertical diplopia that worsens with reading or descending stairs and often compensate with a contralateral head tilt. Ver explicação completa e trilha adaptativa →

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