Regenerative Therapy for Ischemic Brain Injury Using Neural Stem Cells: Mechanisms, Enhancement, and Impact on Neurogenesis

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Abstract
Stem cell-based therapies, particularly those involving neural stem cells (NSCs), offer great promise for the treatment of cerebral ischemia, a condition that includes ischemic stroke, cardiac arrest-induced global ischemia, and hypoxic-ischemic encephalopathy. Preclinical models demonstrate that NSC therapy can promote neuroregeneration, reduce inflammation, and improve functional recovery. However, translation into clinical application remains hindered by poor graft survival, limited integration, and adverse microenvironments. To overcome these barriers, multiple stem cell modification techniques have been developed, including metabolic glycoengineering, genetic modification, preconditioning, and biomaterial encapsulation. This chapter reviews the pathophysiology of cerebral ischemia, the mechanisms of NSC therapy, and advanced bioengineering strategies to enhance stem cell therapeutic efficacy across different ischemic models.

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