Preheat oven to 350 degrees F.
Line baking sheet with foil and spray with olive oil.
Wipe off mushroom caps with damp cloth to remove dirt
Line up mushroom caps with the cavity side facing up on the baking sheet.
Brown ground sausage in skillet. Drain any excess grease.
Chop up mushroom stems.
Add mushroom stems, onion and garlic to ground sausage and allow to cook through.
Remove from heat.
Add the almond meal, parmesan cheese and cream cheese.
Mix until cream cheese has melted and is thoroughly mixed in.
Stuff mixture into mushroom caps.
Sprinkle a little parmesan cheese on top.
Bake at 350 for 25-30 minutes.