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Cook pasta according to package directions. Drain and set aside.
Meanwhile, in a large skillet over medium heat, cook sausage, onion, garlic, and pepper flakes, stirring, for 4–5 minutes, or until meat is no longer pink. Drain excess fat.
Stir in tomatoes, cream, salt, basil, and ½ cup Parmesan and bring to a boil.
Reduce heat and simmer, uncovered and stirring occasionally, for 6–8 minutes or until thickened.
Add pasta to sausage mixture and toss.
Garnish with remaining ½ cup Parmesan before serving.