Which of the following indicates signs of acute papilloedema?

Acute papilloedema refers to the swelling of the optic disc due to increased intracranial pressure and can present with several clinical signs. Among these, both cotton wool spots and peripapillary hemorrhages are significant indicators.

Cotton wool spots are soft, fluffy white patches on the retina that represent areas of localized ischemia or retinal nerve fiber layer thickening. Their presence can indicate underlying vascular issues and is often associated with acute changes in the retina, including those resulting from increased intracranial pressure, which can accompany acute papilloedema.

Peripapillary hemorrhages, which are small bleedings near the optic disc, occur as a result of the increased pressure impacting the small blood vessels. This is characteristic of papilloedema as the optic disc becomes engorged, leading to the rupture of these small vessels.

Both of these findings provide valuable clues to assess the severity and implications of increased intracranial pressure, making their presence indicative of acute papilloedema. The combination of these two signs reinforces the diagnosis significantly more than either sign alone, presenting a more comprehensive view of the pathophysiological changes occurring in the eye as a response to acute intracranial pressure increases.