虽然减压半颅骨切除术（DHC）是恶性中大脑动脉梗死（mMCAi）患者的救命治疗策略，但根据以前的研究，只有四分之一的患者实现了低到中度的中风后残疾。然而，以往研究的短期随访期可能高估了恶化的临床预后。因此，本研究考察了DHC治疗mMCAi后的长期效果。我们回顾性纳入了2006年至2019年期间在格拉茨大学医院接受DHC治疗的所有mMCAi患者，从电子病历中收集人口统计学、临床数据和并发症信息。为调查长期预后，所有患者都在中风后进行了长达14年的随访，包括生活质量评估。中风后残疾程度根据修正Rankin评分（mRS）评估。在接受DHC治疗的47名mMCAi患者中，有40名患者提供了随访数据（平均年龄：48岁；40%为女性）。mMCAi后的6个月内，14名患者死亡（35%），9名患者（23%）出现了轻到中度的中风后残疾（mRS 0-3）。在26名中风幸存者中，其中一半（50%）在长期随访期间显示了进一步的mRS改善（≥1分）（平均随访时间：8年）。最后一次随访时，17名患者实现了≤3的mRS评分（与6个月后的35%相比，65%；p = 0.008），55%没有抑郁和焦虑的迹象，50%没有生活质量评估中的疼痛或不适症状。本研究显示，在DHC治疗后，mMCAi患者的功能残疾和合理的生活质量有显著的长期改善。©2023年作者。

Although decompressive hemicraniectomy (DHC) is a lifesaving treatment strategy for patients with malignant middle cerebral artery infarction (mMCAi), only one in four patients achieves low to moderate post-stroke disability according to previous studies. However, the short follow-up periods in prior studies could have overestimated the poor clinical prognosis. This study therefore examined the long-term outcome after DHC for mMCAi.We retrospectively included all patients who had undergone DHC after mMCAi at the University Hospital Graz between 2006 and 2019. Demographics, clinical data and complications were collected from electronic clinical patient records. To investigate long-term prognosis, all patients were followed up to 14 years after stroke including quality of life (QOL) assessment. Post-stroke disability was rated according to the modified Rankin Scale (mRS).Of 47 patients that had undergone DHC for mMCAi, follow-up data were available in 40 patients (mean age: 48 years; 40% female). Six months after the mMCAi, 14 patients had died (35%) and nine (23%) had a low to moderate post-stroke disability (mRS 0-3). Of 26 stroke survivors, half (50%) showed further mRS improvement (≥ 1 point) during the long-term follow-up period (mean follow-up time: 8 years). At last follow-up, 17 patients had achieved an mRS score of ≤ 3 (65% versus 35% after 6 months; p = 0.008) and 55% had no signs of depression and anxiety, and 50% no signs of pain or discomfort in QOL assessment.This study shows substantial long-term improvement of functional disability and reasonable QOL in mMCAi patients after DHC.© 2023. The Author(s).