I personally think ACM and SM would bring more restrictions than a shunt would. I have very few restrictions (no rough contact activity such as rugby, football, etc, which I can't do, anyway ), but I know someone who has ACM and may have SM (being checked as I'm speaking), and I know from those forums that there's a lot more to be concerned with, such as sitting with head back at the salon. Your best bet is to ask the patient's nsg, because different patients have varying dos and don'ts.