Fig. 1

Electrocardiogram and imaging findings in the case with co-occurrence of moyamoya syndrome and Kartagener syndrome. a, Electrocardiogram showed inverted “P” waves in L1 and AVL on left-sided chest leads. b, Computed tomography scan of the chest revealed bronchiectasis changes, and the cardiac shadow and apex on the right side, and aortic arch, situs inversus. c, The brain magnetic resonance imaging showed acute cerebral infarction in the right basal ganglia region, semi-oval center, insular lobe and frontal parietal lobe. The left coronal areas and left semi-oval central area has old ischemic area (circle). Magnetic resonance angiography revealed severe stenosis at the bilateral terminal portion of the internal carotid arteries while the bilateral middle cerebral arteries and anterior cerebral arteries had almost disappeared. d, Digital subtraction angiography showed inversion of the aortic arch, bilateral internal carotid arteries are occluded at the ophthalmic segment