Brief Answer:
I think stereotactic evacuation of abscesses is necessary.

Detailed Answer:
Hello and welcome to "Ask a Doctor " service.

I have read your query and the reports you uploaded.

Regarding the patient, imaging studies findings and his medical history ( repeated blood transfusions ), most likely the cause of coma and seizures are multiple intracerebral abscesses ( ring enhancing lesions with perifocal edema, that show restriction in diffusion weighted imaging).

In this setting, given the patient medical condition, I think that there is necessary to evacuate surgically these abscesses for two reasons:

1- to improve the patient's overall condition and

2- to isolate the microorganism that is causing the infection and to evaluate the sensitivity to the antibiotics.

This can be done by stereotactic surgery.

Get a neurosurgical consultation.

Hope you found the answer helpful.

Let me know if I can assist you further.

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