A lead anchor assembly includes a burr hole cover that defines a first lead aperture in a side exterior surface, a second lead aperture in a bottom exterior surface, and a fastener aperture. An anchoring unit is disposed in the burr hole cover and includes a fastener for anchoring a lead to the burr hole cover. A lead pathway is defined through the burr hole cover and the anchoring unit. The lead pathway extends from the first lead aperture to the second lead aperture and is configured to receive a lead. A fastener pathway is defined through both the burr hole cover and the anchoring unit and intersects the lead pathway at an anchoring location. The fastener pathway is configured for movement of the fastener along the fastener pathway to engage and disengage the lead when the lead extends along the lead pathway across the anchoring location.