Clearly, a genuine collaboration that respectfully encourages involvement of all interested
parties could lead to the most objective, efficient and conclusive scientific investigations of CCSVI, but make no mistake; this will require the successful tackling of many tough challenges. Daunting impediments include: vested interests, silos with different cultures, hidden agendas, and diverse levels of understanding, strong egos, messenger killers, entrenched dogmatists, sanctimonious pontificators, cynical nihilists, and a whole range of biases.