My wife, daughter, and I went to Pinhead Susan's for an early dinner last. We arrived at about 5:30 on a Monday night. The place was almost empty, so it was fairly quiet, but I can see how it could get loud with lots of people. The decor is a nice combination of brick, wood, and old photos and knick-knacks. My wife and I had burgers with Irish Fries (french fries made with sweet potatoes), my daughter (8 yr. old) had grilled cheese with bacon (anything is better with bacon). Both the food and service were very good.
A feature that some might consider an annoyance is that Pinhead's is adjacent to the rail road tracks. While we were there (about an hour) one passenger train and two freight trains came through. You could really feel the rumble of the locomotives, but the noise from the train wasn't very bad.
Pros: Very nice atmopsphere
Cons: Could get loud