Mechanisms of Neural Stem Cell Mediated Neurogenesis and Therapeutic Prospects Following Ischemic Stroke: A Review

Ischemic stroke is a refractory cerebrovascular disorder characterized by high incidence, disability, and mortality rates. Its core pathological features include extensive neuronal death within the ischemic zone and irreversible damage to neural circuits. Given the limited regenerative capacity of the central nervous system, regulating endogenous neurogenesis and reconstructing functional circuits are important strategies for treating neurological deficits. This narrative review summarizes the dynamic processes of activation, proliferation, migration, and differentiation of endogenous neural stem cells (NSCs) following ischemic stroke, and explores the therapeutic potential of exogenous NSC transplantation and its current applications. Distinct from existing reviews, this work systematically integrates neuroimmune crosstalk, metabolic reprogramming, and meningeal‑choroid‑plexus‑mediated niche regulation, further proposing a staged multimodal precision intervention framework. We also highlight critical confounding factors, including aging‑driven regenerative decline, and explicitly separate preclinical animal findings from limited human clinical evidence. Meanwhile, this review elucidates the core mechanisms through which neurogenesis mediates tissue repair and functional recovery in ischemic brain tissue. Furthermore, this review refines future research directions, such as spatiotemporally specific precision interventions and multimodal combination therapies, providing a systematic theoretical basis and research framework for developing novel NSC‐based therapeutic strategies for ischemic stroke.