{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:02:21Z","timestamp":1790103741226,"version":"4.0.1"},"reference-count":118,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sci.","Brain Sciences"],"abstract":"<jats:p>Traumatic brain injury and pediatric concussion represent major global public health concerns. This narrative review aims to provide an updated overview of pediatric concussion by integrating current evidence regarding pathophysiology, diagnostic advances, neuroimaging, biomarkers, and evidence-based management strategies. Concussion pathophysiology involves a complex neurometabolic cascade characterized by ionic imbalance, mitochondrial dysfunction, cerebral blood flow alterations, diffuse axonal injury, and neuroinflammation. In pediatric populations, unique neurodevelopmental vulnerabilities (higher head-to-torso ratio, weaker cervical musculature, ongoing myelination) magnify these disturbances. Contemporary management has evolved from prolonged rest to early active recovery, incorporating brief initial rest (24\u201348 h) followed by sub-symptom threshold aerobic exercise, structured return-to-learn accommodations, and stepped return-to-sport protocols. Emerging diagnostic tools include the Child SCAT6\/Child SCOAT6, vestibular\/ocular motor screening, and blood biomarkers (GFAP, UCH-L1, NfL). Future research should focus on standardizing pediatric biomarker thresholds and validating multimodal diagnostic algorithms through prospective multicenter studies.<\/jats:p>","DOI":"10.3390\/brainsci16090998","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:56:41Z","timestamp":1790099801000},"page":"998","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Mild Traumatic Brain Injury and Concussion: Modern Pathophysiological Insights, Diagnostic Advances, and Active Management Protocols"],"prefix":"10.3390","volume":"16","author":[{"given":"Mirjana","family":"Raicevic","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University Children\u2019s Hospital, Tirsova St. 10, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3142-2199","authenticated-orcid":false,"given":"Srdjan S.","family":"Nikolovski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Children\u2019s Hospital, Tirsova St. 10, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, Dr. Subotica St. 8, 11000 Belgrade, Serbia"},{"name":"Department of Pathology and Laboratory Medicine, Loyola University Chicago Medical Center, 2160 S First Ave, Maywood, IL 60153, USA"},{"name":"Serbian Resuscitation Council, Dr. Djordja Joanovica St. 2, 21000 Novi Sad, Serbia"},{"name":"Faculty of Pharmacy Belgrade, University Educons, Poenkareova St. 14, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e182853","DOI":"10.1001\/jamapediatrics.2018.2853","article-title":"Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children","volume":"172","author":"Yeates","year":"2018","journal-title":"JAMA Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1089\/neu.2025.0039","article-title":"Global, Regional, and National Burden of Traumatic Brain Injury, 1990\u20132021: A Systematic Analysis for the Global Burden of Disease Study 2021","volume":"42","author":"Gu","year":"2025","journal-title":"J. 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