Preheat your oven to 400°F. Slice the top off the head of garlic to expose the cloves, drizzle with a little olive oil, wrap in aluminum foil, and roast for about 30-35 minutes until soft and fragrant.
While the garlic is roasting, cook the pasta according to package instructions until al dente. Drain and set aside, reserving 1 cup of pasta water.
In a large skillet, heat the olive oil over medium heat. Add the Italian sausage, breaking it apart with a spoon, and cook until browned and cooked through, about 5-7 minutes.
Once the garlic is done roasting, squeeze the softened cloves into the skillet with the sausage. Stir to combine.
Pour in the white wine, scraping up any browned bits from the bottom of the skillet. Let it simmer for about 3-5 minutes until slightly reduced.
Stir in the heavy cream and Parmesan cheese, mixing until smooth. If the sauce is too thick, add a little reserved pasta water until desired consistency is reached.
Add the cooked pasta to the skillet, tossing to coat in the sauce. Season with red pepper flakes, salt, and pepper to taste.
Serve immediately, garnished with fresh parsley and extra Parmesan cheese if desired.