Traumatic pediatric bear injury resulting in cerebrospinal fluid leakage

Cerebrospinal fluid (CSF) leakage is a known sequela of open traumatic skull fractures within the pediatric traumatic brain injury population. Black bears are a known entity within the region of northeast Pennsylvania. It is plausible to have a bear-human interaction resulting in significant bodily injury. A 15-month-old male presented in May 2023 as a level 1 trauma alert for a concerning wound at the base of the skull leaking clear fluid; suspicious for CSF. As a result of this interaction, significant bodily injury can occur, such as CSF leaks and traumatic skull fractures. Living in a region within a known bear population poses a minimal risk of injury. Pediatric populations are usually at a low risk for traumatic CSF leaks. Most of the CSF leaks will resolve spontaneously, without acute surgical intervention, as was seen in our patient after a traumatic bear mauling.