various methods of neuroimaging, commonly including magnetic resonance imaging (mri) and computed tomography (ct). neuroimaging techniques can detect changes occurring in the brain through technology, further implying brain damage caused by a concussion. neuroimaging is a less common technique utilized for pediatrics, as there may be obstacles such as procedural difficulties or discomfort of a pediatric patient. treatment infants, adolescents and children suspected of having a concussion are recommended to seek immediate medical attention. those with red flag symptoms should go to the nearest emergency room or call an ambulance (emergency medical service transport). treatments vary to provide recovery from the trauma; specific treatment depends on the severity and area of injury. medical clearance is not necessary to return to school for pediatric patients. however, observation is required to monitor return-to-school and activities. re-injury should be avoided to prevent long-term consequences and permanent brain damage. rest and return to activities immediately after a person hits their head and concussion is suspected they must be removed from the activity and require a medical assessment before returning to play. after an initial rest of 24 – 48 hours, activities should be gradually started again.activities involving contact, collision or any risk of another hit to the body or head need to be completely avoided until medical clearance is granted. return-to-school after a brief 1-2 days of rest, school activities should be started. absences of more than 1 week are discouraged to avoid deterioration of the manifestations and are recommended to take an active rehabilitation instead. medication pharmacologic treatment at the present stage has been shown to be unable to speed the recovery of pediatric concussion; nevertheless, the medication can be prescribed to alleviate signs and symptoms of sleep disturbances, headaches, cognitive and emotional inflictions, of the injury. melatonin can assist patients experiencing sleep disturbances. medication utilized for headaches like naproxen, ibuprofen, acetaminophen, and oxaprozin can be applied to lessen symptoms in the short term; though, recent studies indicate patients improved in the ailment after discontinuation of the treatment. however, medication and other forms of drugs are advised to not be administered unless prescribed by a doctor due to the potential detrimental implications on recovery. prognosis the majority of pediatric patients recover completely from concussion; some may experience prolonged recuperation. around 70-80% recover without difficulties after one to three months following the concussion. each child's recovery follows a unique direction; an accurate prediction based on a single factor is unable to determine the outcome of the child. health care professionals may occasionally employ prognostic tools to provide assistance to determine a predictive outcome, such as validated symptoms scales, cognitive tests and balance testing. although these tests are incapable of being a strong predictive tool for outcomes, they are able to assess recovery from the pediatric concussion. these tools display greater benefits towards older adolescents for determining predictions for prognosis. in pediatric patients at risk for persistent symptoms, including factors such as premorbid history, demographics and injury characteristics, health care professionals may closely monitor these children and refer to interventions if indications do not resolve within four to six weeks. children suspected of a threat for delayed recovery are highly likely for intervention and will assess prognostic risk factors for effectively counselling patients. presently, there is no test to accurately determine the recovery estimate of pediatric patients who had a concussion. epidemiology concussions are one of the most common traumatic head injuries involved with sports or injuries; children under the age of eighteen having the highest rate among all age groups. among various sports that were observed, soccer was found to have the highest number of concussions followed by football and basketball, respectively. male pediatric patients had more incidence of concussions than females within sports-related concussion occurrences. within different levels of schools (elementary, middle, and high school), the incidence of concussions was highest in high schoolers (43.1%) compared to elementary (25%) and middle schoolers (31.9%). most of the concussions in a school setting were associated with physical education (pe) class being sports-related as well as opposed to during recess, walking in the hall, or in a classroom. among children that were diagnosed with concussions, there was not a significant difference in rate of concussions between males and females. despite the pediatric population having the highest rate of concussions among all age groups, the pediatric population has the lowest rate of loss of consciousness accompanying the concussion among all age groups. among children attending school following a pediatric concussion, 13.7% continued to be symptomatic 3 months afterwards; this could not be explained by trauma, family dysfunction, or psychological adjustment. the most recent estimated range of concussions among patients 18 years of age or younger is between 1.1 million to 1.9 million concussions annually. the estimate is a wide range due to the difficulty of accurately reporting because of differing definitions used, lack of surveillance systems, and possible underreporting of the condition. also, there are differences on what type of patients are used as study subjects within studies to estimate the incidence. many studies use emergency department visits as a proxy for the estimate; however, recently it was found that about 75% of 5-17 years old patients visited their primary care provider to be diagnosed with a concussion. the rate of incidence of concussions, in general, decreases with age; the younger generation experience head traumas more often. however, overall the number of pediatric patients diagnosed with a concussion has increased from 2013 to 2018. this increase of diagnoses could be related to increased frequency of injury, increased participation in sport activities, and more awareness around concussions. the awareness in turn has led to an increased production of policies and procedures dealing with detection, managing symptoms, and return-to-play protocols among sports organizations and schools.