Introduction: This review aims to summarize the possible action mechanism, research progress, and clinical transformation trend of Neural Stem Cells (NSCs) in treating ischemic stroke based on current evidence. Methods: In this review, PubMed, EMBASE, and Science Direct were systematically searched from inception to 2025 using a combination of subject headings and keywords including “neural stem cells”, “ischemic stroke”, “cerebral infarction”, “mechanism”, “signaling pathway”, and “clinical trial”, with search strategies adapted to each database's specific terminology. The selected literature spans basic and translational research on NSC therapy for ischemic stroke, emphasizing molecular mechanisms. Results: NSC transplantation promotes neural repair through multi-dimensional synergistic mechanisms. Structurally, transplanted NSCs migrate to the infarct area, differentiate into mature neurons and glial cells, and integrate into the host neural network, restoring ultrastructure and the neurovascular unit. Functionally, these changes reduce stroke damage and improve motor and cognitive outcomes, supported by long-term anti-inflammatory, metabolic, and regenerative effects. NSCs secrete trophic factors, such as BDNF and VEGF, that enhance cell survival and repair; recent advances in genetic engineering further enhance their therapeutic efficacy. Discussion: Early clinical studies confirm NSC therapy safety and show functional recovery. However, significant challenges remain. These include tumorigenicity risk, inconsistent efficacy, and lack of cell source standardization. Addressing these gaps is essential for clinical translation. Conclusion: NSC therapy offers promise for ischemic stroke treatment. Future research must ensure safety, establish standardized protocols, and elucidate mechanisms to facilitate precise clinical application.
Yu et al. (2026) studied this question.