<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 9-year-old girl is brought to the emergency department with a headache and double vision 1 hour after being hit on the head while playing with a friend. Her friends elbow struck her head, just above her left ear. She did not lose consciousness, but her mother reports that she was confused for 20 minutes after the incident and did not recall being hit. She appears healthy. She is alert and oriented to person, place, and time. Her temperature is 37.2C 99F, pulse is 86min, respirations are 15min, and blood pressure is 11878 mmHg. Examination shows the head tilted toward the right shoulder. A photograph of the eyes at primary gaze is shown. There is mild tenderness to palpation over the left temporal bone. Visual acuity is 2020 in both eyes when tested independently. The patients left eye hypertropia worsens with right gaze and when the patient tilts her head toward her left shoulder. The pupils are equal and reactive to light. Muscle strength and sensation are intact bilaterally. Deep tendon reflexes are 2 bilaterally. Plantar reflex shows a flexor response. Which of the following is the most likely cause of this patients ocular symptoms?? A: Oculomotor nerve damage, B: Retrobulbar hemorrhage, C: Trochlear nerve damage, D: Medial longitudinal fasciculus damage, E: Dorsal midbrain damage,  <response>: This is a clinical vignette describing a 9-year-old girl who presents with headache and double vision after sustaining blunt head trauma. The key findings are left temporal tenderness, left hypertropia worsening with right gaze and left head tilt, intact extraocular movements, and no other focal neurological deficits. This localization is most consistent with injury to the trochlear IV cranial nerve. The trochlear nerve innervates the superior oblique muscle, which depresses and intorts the eye when contracting. Damage causes hypertropia and vertical diplopia worsening with contralateral gaze and ipsilateral head tilt, as the unopposed action of the inferior oblique pulls the eye up and out. Oculomotor nerve damage would cause a dilated, poorly reactive pupil and limitations in nearly all extraocular movements. Retrobulbar hemorrhage causes proptosis and ophthalmoplegia. Medial longitudinal fasciculus damage causes internuclear ophthalmoplegia. Dorsal midbrain damage could cause paralysis of upgaze.C: Trochlear nerve damage 