Numerous studies conducted in recent decades have generated vast amounts of knowledge on sport-related concussions. This review analyzes international data on pediatric and adolescent sport-related concussions. Drawing on the most recent research into the pathophysiology of brain concussions, the authors identify and discuss “pain points” associated with SRC, i.e. unsolved problems of diagnostic criteria, the use of modern neuroimaging modalities and promising biomarkers. Special attention is paid to the physiology of children and adolescents and predisposing factors important for developing adequate diagnostic and management strategies. The authors formulate problems that need to be solved in order to improve care for young athletes with brain concussions.