One who is microcephalic. The most famous pinhead today is Zippy the Pinhead.

Literally, the head of a pin (the side of the pin that is not sharp, usually having a small ball on it). Usually small, being only a millimeter or two in diameter. The derisive use of the word can not only refer to the person's crainial capacity, but also to the fact that they are just not "sharp" (quick witted, intelligent, etc)

Pinhead is a nickname for the lead Cenobite in the movie Hellraiser. Formerly Captain Elliot Spencer, Pinhead now leads Leviathan's Cenobites. Pinhead was created after the first world war, but his Cenobite half (Xipe Totec) is rumored to be somewhat older. Pinhead first appeared in Hellraiser, and was reportedly destroyed in Hellbound: Hellraiser 2. Unfortunately (prepare for a lame horror sequel excuse) Captain Spencer's Cenobite half was to evil to be contained, and was set free from hell. Pinhead's head is decorated with a grid of slices with a nail penetrating each intersection. He wears a black leather outfit with holes that show the open wounds on his chest. Pinhead is masterfully played by Doug Bradley, who was the only saving grace in recent sequels.

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