A burr hole cover is configured to be recessed in a burr hole formed in a patient and includes a base and a cap provided with complementary features to allow a portion of a medical device, such as a brain lead, to be situated in the burr hole cover and then secured by rotation of the cap relative to the base. The features include channels on the base and matching cut-outs on the cap, and slots and locking pockets on the base that are configured to be aligned with locking tabs and locking protrusions on the cap. Because the burr hole cover is recessed in the burr hole, the medical device can extend proximally of the burr hole at the level of the cranium. A bottom surface of the cap may be provided with guides for the lead extending distally in towards the brain.